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Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention
BACKGROUND: Radial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. METHODS AND RESULTS: In total, 568 patients u...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523781/ https://www.ncbi.nlm.nih.gov/pubmed/28159821 http://dx.doi.org/10.1161/JAHA.116.005029 |
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author | Lavi, Shahar Cheema, Asim Yadegari, Andrew Israeli, Zeev Levi, Yaniv Wall, Sabrina Alemayehu, Mistre Parviz, Yasir Murariu, Bogdan‐Dorian McPherson, Terry Syed, Jaffer Bagur, Rodrigo |
author_facet | Lavi, Shahar Cheema, Asim Yadegari, Andrew Israeli, Zeev Levi, Yaniv Wall, Sabrina Alemayehu, Mistre Parviz, Yasir Murariu, Bogdan‐Dorian McPherson, Terry Syed, Jaffer Bagur, Rodrigo |
author_sort | Lavi, Shahar |
collection | PubMed |
description | BACKGROUND: Radial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. METHODS AND RESULTS: In total, 568 patients undergoing transradial diagnostic cardiac catheterization were randomly assigned to either 20 minutes (ultrashort) or 60 minutes (short) hemostatic compression time using patent hemostasis. Subsequently, clamp pressure was reduced gradually over 20 minutes. Access site hemostasis and RAO were assessed after clamp removal. Repeated assessment of RAO was determined at 1 week in 210 (37%) patients. Mean age was 64±11 years, and 30% were female. Percutaneous coronary intervention was performed in 161 patients. RAO immediately after clamp removal was documented in 14 (4.9%) and 8 (2.8%) patients in the 20‐ and 60‐minute clamp application groups, respectively (P=0.19). The incidence of grade 1 hematoma was higher in the 20‐minute group (6.7% versus 2.5%, P=0.015). RAO at 1 week after the procedure was 2.9% and 0.9% in the 20‐ and 60‐minute groups, respectively (P=0.36). Requirement for clamp retightening (36% versus 16%, P=0.01) was higher among patients who had RAO. Need for clamp retightening was the only independent predictor of RAO (P=0.04). CONCLUSIONS: Ultrashort radial clamp application of 20 minutes is not preferable to a short duration of 60 minutes. The 60‐minute clamp duration is safe and provides good access site hemostasis with low RAO rates. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02269722. |
format | Online Article Text |
id | pubmed-5523781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55237812017-08-14 Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention Lavi, Shahar Cheema, Asim Yadegari, Andrew Israeli, Zeev Levi, Yaniv Wall, Sabrina Alemayehu, Mistre Parviz, Yasir Murariu, Bogdan‐Dorian McPherson, Terry Syed, Jaffer Bagur, Rodrigo J Am Heart Assoc Original Research BACKGROUND: Radial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. METHODS AND RESULTS: In total, 568 patients undergoing transradial diagnostic cardiac catheterization were randomly assigned to either 20 minutes (ultrashort) or 60 minutes (short) hemostatic compression time using patent hemostasis. Subsequently, clamp pressure was reduced gradually over 20 minutes. Access site hemostasis and RAO were assessed after clamp removal. Repeated assessment of RAO was determined at 1 week in 210 (37%) patients. Mean age was 64±11 years, and 30% were female. Percutaneous coronary intervention was performed in 161 patients. RAO immediately after clamp removal was documented in 14 (4.9%) and 8 (2.8%) patients in the 20‐ and 60‐minute clamp application groups, respectively (P=0.19). The incidence of grade 1 hematoma was higher in the 20‐minute group (6.7% versus 2.5%, P=0.015). RAO at 1 week after the procedure was 2.9% and 0.9% in the 20‐ and 60‐minute groups, respectively (P=0.36). Requirement for clamp retightening (36% versus 16%, P=0.01) was higher among patients who had RAO. Need for clamp retightening was the only independent predictor of RAO (P=0.04). CONCLUSIONS: Ultrashort radial clamp application of 20 minutes is not preferable to a short duration of 60 minutes. The 60‐minute clamp duration is safe and provides good access site hemostasis with low RAO rates. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02269722. John Wiley and Sons Inc. 2017-02-03 /pmc/articles/PMC5523781/ /pubmed/28159821 http://dx.doi.org/10.1161/JAHA.116.005029 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Lavi, Shahar Cheema, Asim Yadegari, Andrew Israeli, Zeev Levi, Yaniv Wall, Sabrina Alemayehu, Mistre Parviz, Yasir Murariu, Bogdan‐Dorian McPherson, Terry Syed, Jaffer Bagur, Rodrigo Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title_full | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title_fullStr | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title_full_unstemmed | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title_short | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
title_sort | randomized trial of compression duration after transradial cardiac catheterization and intervention |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523781/ https://www.ncbi.nlm.nih.gov/pubmed/28159821 http://dx.doi.org/10.1161/JAHA.116.005029 |
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