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3 Evaluation of the incidence of radial artery occlusion and other complications after TR band application with 11 ml (reduced) v’s 15 ml (standard) of air
  1. S Neoh,
  2. C O’Callaghan,
  3. D Mulcahy,
  4. T Kok,
  5. B Loo
  1. Tallaght Hospital, Dublin, Ireland

Abstract

Objective To evaluate if a reduction in air inflation volume in a commercial radial artery compression device (TR band, Terumo, Japan) maintains adequate patent haemostasis whilst reducing access site complications including radial artery occlusion.

Methods Ninety- five consecutive patients undergoing diagnostic day case transradial angiography were prospectively enrolled in the study. 47 patients were in the study group and 48 in the control group. Following the procedure, a TR band was used for arterial haemostasis and was inflated with a reduced volume of 11 ml of air in the study group or 15 ml of air in accordance to manufacturer recommendations in the control group. At baseline, radial artery patency was documented using the reverse Barbeau test and radial artery Doppler studies. Post-procedure patency of the radial artery was documented using the reverse Barbeau test and Doppler studies. A pre discharge and 30 day follow up of patients was performed for radial artery patency and access site complications.

Results Immediately post-procedure, there were significantly fewer patients with a negative reverse Barbeau test as an indicator of radial arterial occlusion in the study group than the control group (2% vs. 48%, p < 0.001). Pre discharge, no patient in the study group had a negative Barbeau test compared to 6% in the control group. There were also fewer incidences of pain/discomfort and bruising in the study group (0% vs. 10% for pain/discomfort and 6% vs. 8% for bruising, p = 0.023). At 30 day follow-up, 4 patients in the control group had persistently negative reverse Barbeau test, of which 3 had radial artery occlusion. No patient in the study group had delayed radial artery occlusion (p = 0.043). Persistent pain/discomfort was also significantly less in the study group (2% vs. 12.5%, p = 0.029).

Conclusion A reduced air volume of 11 ml in a TR band maintained adequate patent haemostasis with fewer incidences of acute and delayed radial artery occlusion following transradial angiography compared to the standard recommended inflation volume of 15 ml. In addition, there were fewer incidences of access site pain and discomfort at 30 day follow-up in this group.

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