title: An accelerated hemostasis protocol following transradial cardiac catheterization is safe and may shorten hospital stay: a single-center experience.
abstract: BACKGROUND
  Hemostasis following transradial cardiac catheterization is achieved by external pressure application using various devices, TR Band being one. There is no standardized protocol for the application and removal of such devices.
  
  
  OBJECTIVE
  To assess the safety and feasibility of a more rapid (1 hour) initiation of TR Band removal ([time to wean] TTW1) compared to a recommended 2 hour protocol (TTW2) in a controlled prospective study.
  
  
  METHODS
  100 consecutive outpatients undergoing diagnostic transradial cardiac catheterization prospectively underwent an accelerated initiation of post-procedure TR Band removal (TTW1 group). The controls were a random historical cohort of 25 patients who had the conventional 2 hours to wean approach (TTW2).
  
  
  RESULTS
  The mean age was 62 years with a mean BMI of 29 kg/m(2); 51% were hypertensive and 9% were on warfarin anticoagulation. As defined, the median times to TR Band weaning were 60 minutes and 120 minutes for TTW1 and TTW2 groups, respectively, p < 0.001. TTW1 patients had more oozing leading to insignificant delay in the weaning process (16% vs 4% in the TTW2 group, p = NS). The total time, however, from TR Band application to removal was significantly shorter in the TTW1 group compared to TTW2 (median of 120 minutes [mean 127] vs 180 minutes [mean 187], p < 0.001). There were no differences in any prespecified complications.
  
  
  CONCLUSIONS
  A rapid 1-hour commencement of TR Band weaning following transradial diagnostic cardiac catheterization appears to be safe. It shortens the overall device removal time and may shorten hospital stay in day-case procedures.
authors.affiliation: From the Cardiovascular Unit, Department of Cardiology, North Shore Hospital, Auckland, New Zealand. chris.carrington@waitematadhb.govt.nz
authors.forename: Chris
authors.initials: C
authors.lastname: Carrington
authors.forename: Rose
authors.initials: R
authors.lastname: Mann
authors.forename: Seif
authors.initials: S
authors.lastname: El-Jack
mesh_terms: D015992:Body Mass Index; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D002985:Clinical Protocols; D005240:Feasibility Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006487:Hemostasis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011446:Prospective Studies; D017534:Radial Artery; D013997:Time Factors