New device for compression of the radial artery after diagnostic and interventional cardiac procedures.
Recently the transradial route has emerged as a valuable alternative to the femoral approach for coronary angiography and angioplasty. However, sheath and catheter size and their immediate removal after the procedure, combined with aggressive antiplatelet and anticoagulant therapies, have favored mechanical compression of the radial artery to achieve satisfactory hemostasis. We report on our initial clinical experience with a new device specially designed for prolonged controlled mechanical compression of the radial artery (the RadiStop radial compression system, RADI Medical Systems AB, Uppsala, Sweden). A total of 159 consecutive patients (mean age 60 +/- 11 yr, 130 males) who required either coronary angiography (group 1, 103 patients) or ad hoc or elective coronary angioplasty (group 2, 56 patients) via the right radial route had local hemostasis with the RadiStop system. In group 1, 4F and 5F sheaths and catheters were used, whereas in group 2, 6F systems were inserted in the radial artery. Hemostasis was achieved with the device in all patients but was considered difficult to obtain in 4 patients (2.5%). Twenty-eight patients (18%) considered the device uncomfortable or painful, but no release of pressure was necessary. The mean compression time was 151 +/- 82 min (114 +/- 64 min in group 1, and 223 +/- 64 min in group 2; P = 0.0001). There were 23 local complications (15%). In 7 patients (4.4%), the radial pulse was absent after compression and at discharge, without major clinical consequences. In one patient, recurrent bleeding occurred 2 hr after compression, requiring a new compression session. In 15 patients, a small local hematoma was observed. Neither heparin dosage nor the use of a 6F sheath affected the rate of radial artery patency in this survey. We conclude that the use of this device for mechanical compression of the radial artery after coronary angiography and angioplasty is efficient, and that its use is related to an acceptable rate of local complications.
Chatelain
P
P
Cardiology Center, University Hospital of Geneva, Switzerland.
Arceo
A
A
Rombaut
E
E
Verin
V
V
Urban
P
P
D000368:Aged; D017130:Angioplasty / Q000379:methods; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods; D004867:Equipment Design; D005260:Female; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures / Q000009:adverse effects; D017534:Radial Artery / Q000503:physiopathology*; D014654:Vascular Patency