Kyriakopoulos V, Xanthopoulos A, Papamichalis M, Skoularigkis S, Tzavara C, Papadakis E, Patsilinakos S, Triposkiadis F, Skoularigis J. Patent hemostasis of radial artery: Comparison of two methods. World J Cardiol 2021; 13(10): 574-584 [PMID: 34754402 DOI: 10.4330/wjc.v13.i10.574]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Consultant Physician-Scientist, Department of Cardiology, University Hospital of Larissa, Mezourlo, PO Box 1425, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Oct 26, 2021; 13(10): 574-584 Published online Oct 26, 2021. doi: 10.4330/wjc.v13.i10.574
Patent hemostasis of radial artery: Comparison of two methods
Vassileios Kyriakopoulos, Andrew Xanthopoulos, Michail Papamichalis, Spyridon Skoularigkis, Chara Tzavara, Emmanouil Papadakis, Sotirios Patsilinakos, Filippos Triposkiadis, John Skoularigis
Vassileios Kyriakopoulos, Emmanouil Papadakis, Sotirios Patsilinakos, Department of Cardiology, Konstantopoulio General Hospital, Athens 14233, Greece
Andrew Xanthopoulos, Michail Papamichalis, Spyridon Skoularigkis, Filippos Triposkiadis, John Skoularigis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Chara Tzavara, Department of Health, Medical School, University of Athens, Athens 11527, Greece
Author contributions: Kyriakopoulos V participated in design of the study, drafted the manuscript and was involved with data collection; Xanthopoulos A participated in design of the study, drafted the manuscript, and participated in oversight of the study; Papamichalis M drafted the manuscript and was involved with data collection; Skoularigkis S participated in design of the study, and was involved with data collection; Tzavara C participated in design of the study and performed statistical analysis; Papadakis E was involved with data collection and drafted the manuscript; Patsilinakos S participated in design and oversight of the study; Triposkiadis F participated in design of the study and drafted the manuscript; Skoularigis J participated in design and oversight of the study and drafted the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the hospital’s ethics review board.
Informed consent statement: Patients participating in the study provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Data sharing statement: No additional data are available
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Consultant Physician-Scientist, Department of Cardiology, University Hospital of Larissa, Mezourlo, PO Box 1425, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: April 21, 2021 Peer-review started: April 21, 2021 First decision: May 13, 2021 Revised: May 24, 2021 Accepted: July 15, 2021 Article in press: July 15, 2021 Published online: October 26, 2021
Abstract
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.
Core Tip: This was a prospective, single center study with 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention. It aimed to evaluate the best method (pulse oximeter vs the traditional radial artery palpation) for successful patent hemostasis. The use of a pulse oximeter increased the probability of achieving patent hemostasis compared with artery palpation, and was associated with lower rates of artery spasm. In the multivariate analysis, the use of pulse oximeter and advanced age were independently associated with an increased probability of successful patent hemostasis.
