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      Do We Still Need to Assess Post-procedural Radial Artery Compression Time and Radial Artery Occlusion in Patients Who Undergo Transradial Coronary Intervention?

      research-article
      1 , , 2
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      Cureus
      Cureus
      radial artery hematoma, trans-radial, radial artery compression time, radial artery occlusion, compression device

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          Abstract

          Background and objective

          Transradial access (TRA) for interventional coronary procedures has now been widely accepted as the preferred vascular site approach. The duration of post-procedure compression has been shown to be a crucial factor and different hemostatic devices used in this regard have been compared. In this study, we aimed to compare the post-procedure compression time, radial artery occlusion (RAO), hematoma, and bleeding between the transradial (TR) band and AIR band for radial artery patency among patients presenting at a tertiary care hospital.

          Methodology

          This observational study was conducted at the Department of Cardiology of Mohammed Bin Khalifa Bin Sulman Al Khalifa Specialist Cardiac Centre, Awali, Bahrain from 06/03/2022 to 05/06/2022. The research involved patients of either gender who had a positive Barbeau test (type A to C) and were receiving percutaneous coronary intervention via a transradial route. Patients who underwent transradial coronary intervention were classified into two separate groups, depending on whether an AIR band (group A) or a TR band (group B) compression was used. Following coronary catheterization, radial hemostatic compression devices were used. The results were documented both during and after the hemostatic compression. The data were analyzed using IBM SPSS Statistics version 23 (IBM Corp., Armonk, NY).

          Results

          Of the total 100 patients included in the study, the majority were males (86%) and aged more than 50 years (83%). AIR band was successfully removed in 32 patients (64%) in less than four hours, compared to the TR band, which was removed in less than four hours in two patients (4%) only (p=0.001). The incidences of bleeding (p=0.790) and RAO (p=0.495) were similar between the AIR band group and the TR band group. Hematoma was not seen in any of the patients in either group.

          Conclusion

          AIR band was observed to be more efficacious in decreasing the radial artery compression time. However, the difference in RAO was insignificant in the short term, and follow-up studies are required to see if the AIR band is associated with any long-term benefits.

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          Most cited references18

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          Percutaneous radial artery approach for coronary angiography.

          Percutaneous entry into the distal radial artery and selective coronarography using a French 5 sheath and preshaded catheters were attempted in 100 patients with a normal Allen test. Cannulation of the radial artery was not possible in ten patients, and selective catheterization of the coronary arteries was unsuccessful in two. Manipulation of catheters presented no problem, and arterial spasm was rarely observed, only before the use of a 23-cm-long sheath. Only two complications without symptoms were observed: arterial dissection of the brachial artery in one patient and occlusion of the radial artery in another. With experience, this approach may become as effective and possibly safer than the transbrachial entry.
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            Transradial vs. Transfemoral Approach in Cardiac Catheterization: A Literature Review

            The main objective of this review paper is to study the comparison between transradial and transfemoral approach in catheterization. Transradial and transfemoral are two main approaches which are used as a diagnostic and therapeutic purpose in catheterization. The transradial approach in interventional cardiology is safe, effective, and feasible as compared to the transfemoral approach. The aim of this study is to compare pros and cons of transradial vs. transfemoral approach in catheterization. We conducted this systematic review on the role of transradial vs. transfemoral catheterization. The articles included real human data on interventional approaches. Reviews on these strategies were conducted in PubMed, medical literature analysis and retrieval system online (MEDLINE), Cochrane, Medscape and National Institute of Health. To maintain a high standard of review, studies published in all non-famous journals were excluded. Data collected from the studies have suggested that transradial approach has less bleeding complications, cost effective, decreased hospital mortality rate, and less access site complications as compared to transfemoral approach. However, longer procedural duration and radiation exposure are still concerns regarding transradial approach. The findings of the present study show that transradial approach in catheterization is safe, effective, and feasible as compared to the transfemoral approach. However, duration and radiation exposure are higher in the transradial access. Several studies suggest that the modern approach overweight in benefits with the comparison to the classical approach.
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              A novel approach to reduce radial artery occlusion after transradial catheterization: postprocedural/prehemostasis intra-arterial nitroglycerin.

              To evaluate whether administration of nitroglycerin through the sheath at the end of a transradial procedure might preserve the patency of the radial artery.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                17 February 2023
                February 2023
                : 15
                : 2
                : e35129
                Affiliations
                [1 ] Interventional Cardiology, Mohammed Bin Khalifa Bin Sulman Al Khalifa Specialist Cardiac Centre, Awali, BHR
                [2 ] Cardiology, Mohammed Bin Khalifa Bin Sulman Al Khalifa Specialist Cardiac Centre, Awali, BHR
                Author notes
                Article
                10.7759/cureus.35129
                10025872
                36945287
                12e71a8b-ab9a-47c3-a13a-53775d9909c4
                Copyright © 2023, Bardooli et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 February 2023
                Categories
                Cardiology

                radial artery hematoma,trans-radial,radial artery compression time,radial artery occlusion,compression device

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