Short Durations of Radial Hemostatic Device After Diagnostic Transradial Cardiac Catheterization: The PRACTICAL-2 Randomized Trial
| Autor: | Amir Solomonica, Rehana Bajwa, Shamir R. Mehta, Klajdi Puka, Shahrukh N. Bakar, Pallav Garg, Pantelis Diamantouros, Cassandra Wagner, Rodrigo Bagur, Shahar Lavi, Hussein Taleb, Kokab Awan, Ayaaz K Sachedina |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_treatment Arterial Occlusive Diseases 030204 cardiovascular system & hematology Postoperative Hemorrhage law.invention 03 medical and health sciences 0302 clinical medicine Hematoma Randomized controlled trial Forearm law medicine.artery Occlusion Catheterization Peripheral medicine Humans 030212 general & internal medicine Radial artery Cardiac catheterization Aged Duration of Therapy business.industry Heparin medicine.disease Hemostasis Surgical medicine.anatomical_structure Outcome and Process Assessment Health Care Anesthesia Radial Artery Female Risk Adjustment Cardiology and Cardiovascular Medicine Complication business medicine.drug |
| Zdroj: | The Canadian journal of cardiology. 37(2) |
| ISSN: | 1916-7075 |
| Popis: | Background Radial artery occlusion (RAO) is the most common complication following transradial approach (TRA) for cardiac catheterization. Our aim was to assess if decreasing radial hemostatic device (RHD) time reduces the risk of RAO among individuals receiving small sheath sizes with no adjunctive heparin. Methods We randomized 450 individuals undergoing diagnostic cardiac catheterization via the TRA to 3 durations of RHD time: 10, 20 or 30 minutes. After this time period, the RHD was gradually released over 20 minutes. The primary efficacy endpoint was forearm hematoma grade ≥2 (5-10 cm) and the primary safety endpoint was RAO (as determined by Doppler ultrasound) one-hour post RHD removal (pre-discharge). Results The mean age was 66 years and 64% were male. 5 French sheaths were used in all patients. Hematoma grade ≥2 occurred only in 1 patient in the 20 minutes groups (P=0.39). RAO occurred in 6.7% of patients in the 10 minute group, 10.7% in the 20 minute group and 6% in the 30 minute group (P=0.26). Conclusion Among patients receiving small caliber sheaths without adjunctive heparin, the incidence of forearm hematoma and RAO are low. Shorter durations of RHD time did not further reduce the risk of these complications. Brief summary We assessed if reducing radial hemostatic device (RHD) time decreases the risk of radial artery occlusion (RAO) in patients undergoing cardiac catheterization via the trasradial approach while small size sheaths and no heparin are used. We randomized 450 individuals into 3 durations of RHD time: 10, 20 or 30 minutes. The incidence of forearm hematoma and RAO were low and not different between groups. |
| Databáze: | OpenAIRE |
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