NEW METHOD OF COMPRESSION AFTER CORONARY ANGIOGRAPHY AND INTERVENTION FROM PROXIMAL AND DISTAL RADIAL APPROACHES IN RANDOMIZED COMPARISON WITH STANDARD COMPRESSION - ANALYSIS OF 500 PATIENTS

Background: Duration and intensity of the radial artery compression after interventional procedures affect the occurrence of postprocedural local complications. We investigated the use of standard mechanical compression and its combination with kaolin-impragnated gauze patch as a new method of hemostasis.
Methods: Five hundred consecutive patients (66±8 years, 75% males) after coronary angiography (70%) and intervention (30%) from the proximal (PRA) and distal radial (DRA) approaches were analyzed. Compression was performed by mechanical inflatable device (TR Band) with or without kaolin gauze - 170 versus (vs.) 170 patients in proximal groups and 80 vs. 80 patients in distal groups. Time to hemostasis and access site complications were analyzed.
Results: Baseline characteristics were similar in all four groups - proximal with kaolin (PK+) and without kaolin (PK-), distal with kaolin (DK+) and without kaolin (DK-). Time to hemostasis was 57±20 min in PK+ vs 83±19 min in PK- group and 48±12 min in DK+ vs. 63±12 min in DK- group (both p<0,001). Compression times in distal groups were significantly shorter in comparison with proximal groups (p<0,001). Hematomas grade I (<5cm) were more often in PRA - 20% vs 7% in DRA and similarly as grade II (<10cm) - PRA 4,4% vs 0,6% in DRA (both p<0,001). Only two patients with PRA had hematomas grade III (>10cm). No patient had postprocedural radial artery occlusion.
Conclusions: The use of the new combined method of radial artery hemostasis was associated with shorter compression time both in PRA and DRA in comparison with standard only mechanical compression. DRA was associated with shorter compression time in both groups compared to PRA and almost absence of any local complications. Local hematomas were dominantly observed in patients with PRA. There were no radial artery occlusion in this analysis.