Accelerated patent haemostasis using a procoagulant disk: a protocol designed to minimise the risk of radial artery occlusion following cardiac catheterisation

Ayyaz Ul Haq, Muhammad; Nazir, Sheraz A.; Rashid, Muhammad; Shing Kwok, Chun; Mubashiruddin, Syed; Alisiddiq, Zaheer; Shoaib b, Ahmed; Ratib, Karim; Mamas, Mamas A; Nolan, James

Abstract

Purpose
Radial artery occlusion flowing cardiac catheterisation has been linked to flow reduction and prolonged compression. We investigate whether these factors can be optimised following transradial cardiac catheterisation by using an accelerated band removal protocol facilitated by a haemostasis promoting pad, in combination with a patent haemostasis technique.

Methods
In this single centre prospective study, 389 consecutive patients undergoing TRA for coronary angiography or angioplasty were randomised to two haemostasis protocols: use of a Helix™ compression device alone (HC) or in combination with a haemostatic pad (StatSeal® disc) and an accelerated haemostasis protocol (AC). A patent haemostasis technique was employed in both study arms. The primary efficacy endpoint was the time to haemostasis and the secondary safety outcome was access site related complications: re-bleeding, haematoma and radial artery patency assessed within 24?h using reverse Barbeau's Test (BT).

Results
Between May and Nov 2017, 191 patients were randomised to receive HC and 198 patients to AC. Compression time was significantly higher with HC as compared to AC (165.8?±?63.1 versus 79.7?±?41.2?min, p?<?0.001). There were no significant differences in re-bleeding and RAO between groups (3.7% versus 5.6%, p?=?0.37 and 6.3% versus 4.1%, p?=?0.33) respectively. Incidence of haematoma was higher in AC group (4.7% versus 12.1%, p?=?0.009).

Conclusion
A reduction in radial artery compression time can be achieved by using Statseal in association with an accelerated haemostasis protocol without increasing the risk of access site bleeding and RAO. The combination of reduced compression time combined with maintained radial flow via patent haemostasis has the potential to reduce the risk of radial occlusion after transradial catheterisation.

Citation

Ayyaz Ul Haq, M., Nazir, S. A., Rashid, M., Shing Kwok, C., Mubashiruddin, S., Alisiddiq, Z., Shoaib b, A., Ratib, K., Mamas, M. A., & Nolan, J. (2019). Accelerated patent haemostasis using a procoagulant disk: a protocol designed to minimise the risk of radial artery occlusion following cardiac catheterisation. Cardiovascular Revascularization Medicine, 20(2), 137-142. https://doi.org/10.1016/j.carrev.2018.03.026

• Journal Article Type: Article
• Acceptance Date: Mar 29, 2018
• Online Publication Date: Apr 21, 2018
• Publication Date: Feb 1, 2019
• Publicly Available Date: May 26, 2023
• Journal: Cardiovascular Revascularization Medicine
• Print ISSN: 1553-8389
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 2
• Pages: 137-142
• DOI: https://doi.org/10.1016/j.carrev.2018.03.026
• Keywords: StatSeal; Helix compression device; Rapid deflation technique
• Public URL: https://keele-repository.worktribe.com/output/410771
• Publisher URL: http://doi.org/10.1016/j.carrev.2018.03.026