Introduction The transradial route for coronary intervention has proven to be safe, effective, and widely applicable in different clinical situations. Several compressive haemostatic devices have been introduced which have shown to be safe and are effective in achieving haemostasis.
Aims of Study Two commonly-used compressive devices to achieve haemostasis after transradial access are the Radistop (RADI, Uppsala, Sweden), and the TR Band (Terumo Inc, Japan). The objectives of our study are to compare the effects of Radistop and TR band on patient's comfort, time taken to achieve haemostasis and local vascular complications.
Methods Seven hundred and ninety patients were randomly assigned to receive either TR band or Radistop after transradial procedure. The outcome measures were patient tolerance of the device, local vascular complications, and the time taken to achieve haemostasis.
Results The mean age was 62.88 years, and 74.2% of the patients were men. Patient age, height, weight, wrist circumference, body mass index, male sex, hypertension, diabetes, hypercholesterolaemia and smoking incidence were similar in both groups. There were significantly more patients reporting no discomfort in the TR band group compared to the Radistop group (77% vs 61%; p=0.0001). Patients in the Radistop group reported significantly more pain across all categories of severity and three patients in the Radistop group were crossed over to TR band because of severe discomfort. Oozing and ecchymosis were seen in about 16% of the patients. Local small haematoma and large haematoma were seen in 5.4%, and 2.2% patients respectively, and similar in both groups. Radial artery occlusion at the time of discharge was seen in 9.2% of the patients though only 6.8% showed persistent occlusion at the time of follow-up. The time taken to achieve haemostasis was significantly longer in the TR Band group (5.32±2.29 vs 4.83±2.23 h; p=0.004). There was significantly higher incidence of radial artery occlusion in patients with smaller wrist circumference, the patients who experienced radial artery spasm during the procedure, and patients with no heparin administration during the procedure.
Conclusions We have shown in a randomised comparison of Radistop and TR band, that both devices are safe and effective as haemostatic compression devices following transradial procedures. However, more patients felt discomfort with the Radistop device and the time taken to achieve haemostasis was longer with TR band.
- haemostatic compression devices
- radial artery occlusion