Patent hemostasis of radial artery:Comparison of two methods

BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial access.Patent hemostasis can significantly reduce the risk of radial artery occlusion.Previous studies utilized sophisticated methods to evaluate radial artery patency.Simplified and easily applicable methods for successful patent hemostasis are currently lacking.AIM To determine which method(pulse oximeter vs the traditional radial artery palpation)is better to achieve patent hemostasis.METHODS This prospective,single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July 2019.Patients less than 18 years old,with a history of radial artery disease,or no palpable artery pulse were excluded from the study.Patients were randomly assigned to two groups.In the first group,radial artery flow was assessed by palpation of the artery during hemostasis(traditional method).In the second group,radial artery patency was estimated with the use of a pulse oximeter.Two different compression devices were used for hemostasis(air chamber and pressure valve).The primary study endpoint was the achievement of successful patent hemostasis.RESULTS The two groups(pulse oximeter vs artery palpation)had no significant differences in age,sex,body mass index,risk factors,or comorbidities except for supraventricular arrhythmias.The percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group(82.2%vs 68.1%,P=0.005).A lower percentage of patients with spasm was recorded in the pulse oximeter group(9.9%vs 19.0%,P=0.024).The incidence of local complications,edema,bleeding,hematoma,vagotonia,or pain did not differ between the two groups.In the multivariate analysis,the use of a pulse oximeter(OR:2.35,95%CI:1.34-4.13,P=0.003)and advanced age(OR:1.04,95%CI:1.01-1.07,P=0.006),were independently associated with an increased probability of successful patent hemostasis.The type of hemostatic device did not affect patent hemostasis(P=0.450).CONCLUSION Patent hemostasis with the use of pulse oximeter is a simple,efficient,and safe method that is worthy of further investigation.Larger randomized studies are required to consider its clinical implications.

Alternative access site choice after initial radial access site failure for coronary angiography and intervention

为冠的 catheterization 的 BackgroundTransradial 存取与传统的 transfemoral 途径相比是更技术上挑战性的，光线的存取失败是相当普通的。学习是在高度在起始的光线的存取地点失败以后描述另外的步的这的目的专业化所有冠的 catheterizations 的回顾的评估在我们在2016年1月之间的部门执行了的前臂途径 center.MethodsA ，2016年12月被执行，与动脉的 access.ResultsOne 的焦点，千三百四十六个过程被评估。使用的起始的存取地点是恰好光线的[1173 过程(87.1%)] ，留给光线[120 过程(8.9%)] ，恰好尺骨[7 过程(0.5%)] ，留给尺骨[40 过程(2.9%)] 并且大腿骨的途径[6 过程(0.4%)] 。光线的动脉管子失败在 37 过程(有起始的光线的途径的 1293 过程中的 2.9% 个) 被观察。在成功的光线的鞘插入以后的过程结束的失败在 46 过程(3.6%) 被观察。在起始的光线的途径失败以后的其他的存取地点是 contralateral 光线[ 43 过程(51.8%)]， ipsilateral 尺骨[ 22 过程(26.5%)， contralateral 尺骨[ 12 个病人(14.5%)]并且大腿骨的途径[ 6 过程(7.2%)] .ConclusionForearm 动脉能在起始的光线的途径失败以后被用作其他的存取地点以便在心脏的 catheterization 期间减少大腿骨的途径的使用。