Randomized Clinical Trial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2017; 9(11): 807-812
Published online Nov 26, 2017. doi: 10.4330/wjc.v9.i11.807
Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel air-inflation technique
Victor Voon, Muhammad AyyazUlHaq, Ciara Cahill, Kirsten Mannix, Catriona Ahern, Terence Hennessy, SamerArnous, Thomas Kiernan
Victor Voon, Muhammad AyyazUlHaq, Ciara Cahill, Kirsten Mannix, Catriona Ahern, Terry Hennessy, SamerArnous, Thomas Kiern, Cardiology Department, University Hospital Limerick, Dooradoyle, Limerick, Ireland
Author contributions: Voon V performed data collection, analyzed and interpreted data, and wrote manuscript; AyyazUlHaq M, Cahill C, Mannix K, Ahern C, Hennessy T, Arnous S performed and conducted data collection; Kiernan T contributed to the conception and design of study and wrote manuscript; all authors critically reviewed the manuscript and approved it.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of University Hospital Limerick, Dooradoyle, Limerick, Ireland.
Informed consent statement: All eligible patients gave written informed consent to participate in the study, prior enrollment.
Conflict-of-interest statement: All authors declare no potential conflicting interests related to this paper.
Data sharing statement: No additional data are available. Technical appendix, statistical code, and dataset available from the corresponding author at victor.voon@gmail.com. Presented data are anonymized and risk of identification is low.
Open-Access: 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/
Correspondence to: Victor Voon, MB, MRCP(UK), Specialist Registrar in Cardiology, Cardiology Department, University Hospital Limerick, Saint Nessan’s Road, Dooradoyle, Limerick, Ireland. kuanjoovoon@beaumont.ie
Telephone: +353-61-585694 Fax: +353-61-485122
Received: May 1, 2017
Peer-review started: May 1, 2017
First decision: July 20, 2017
Revised: August 1, 2017
Accepted: August 15, 2017
Article in press: August 16, 2017
Published online: November 26, 2017
Abstract
AIM

To compare post-percutaneous coronary intervention (PCI) radial artery occlusion (RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.

METHODS

One hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 mL of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P < 0.05.

RESULTS

All patients had 6F radial sheath inserted. No significant differences were observed between Safeguard Radial (n = 42) vs TR band (n = 42) in terms of age (63 ± 11 years vs 67 ± 11 years), clinical presentation (electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin (7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h (2% vs 0%, P = 0.32) and 6 wk (0%, both).

CONCLUSION

Safeguard Radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all post-PCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.

Keywords: Radial artery, Arterial occlusive disease, Cardiac catheterization

Core tip: Radial artery occlusion (RAO) is a rare but significant complication post-transradial percutaneous coronary intervention (PCI). We found that post-PCI Doppler flow signal-detected RAO incidence was not significantly different between Safeguard Radial and TR band compression devices. However, with the use of a novel air-inflation technique, we observed significantly lower incidence of RAO in all patients regardless radial compression device, in the short-term compared to current literature. Therefore, this novel air-inflation technique may offer a pragmatic and effective solution in reducing RAO incidence.