title: Facilitated patent haemostasis after transradial catheterisation to reduce radial artery occlusion.
abstract: OBJECTIVE
  This study sought to evaluate the feasibility of a rapid deflation technique (RDT) after transradial catheterisation to achieve patent haemostasis and to assess whether this could reduce radial artery occlusion (RAO). Ensuring patent haemostasis is the most important factor in reducing RAO. The use of larger sheath sizes and antiplatelet and antithrombotic agents limits achieving patent haemostasis immediately after transradial intervention.
  
  
  RESULTS
  A feasibility assessment was first performed in 105 patients to assess whether RDT could be performed safely and consistently achieve patent haemostasis after transradial catheterisation. Prospective data were then collected on 201 patients who underwent either rapid or standard deflation technique and had RAO assessment at 24 hours. Acute coronary syndrome was the indication for transradial catheterisation in 62.7% of patients. Baseline patent haemostasis increased from 40% to 95% after RDT. RAO at 24 hours was seen in two (2.0%) patients in the RDT group and 15 (14.9%) in the standard deflation group (OR 0.117; 95% CI: 0.026 to 0.526, p=0.005). Other independent predictors of RAO included body surface area (OR 0.022; 95% CI: 0.002 to 0.273, p=0.003) and male sex (OR 0.298; 95% CI: 0.108 to 0.824, p=0.020). No significant difference was found in safety outcomes: need to re-inflate compression band (2% versus 1.8%) or haematoma (0% versus 0.9%).
  
  
  CONCLUSIONS
  Rapid deflation of the compression band after transradial catheterisation is a safe and effective method of achieving patent haemostasis that reduces RAO.
authors.affiliation: Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Edris
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gordin
authors.forename: Tamer
authors.initials: T
authors.lastname: Sallam
authors.forename: Robin
authors.initials: R
authors.lastname: Wachsner
authors.forename: Sheba
authors.initials: S
authors.lastname: Meymandi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Traina
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy*; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011312:Pressure; D011446:Prospective Studies; D011677:Punctures; D017534:Radial Artery / Q000503:physiopathology*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014661:Vasoconstriction