Usefulness of a Gentle and Short Hemostasis Using the Transradial Band Device after Transradial Access for Percutaneous Coronary Angiography and Interventions to Reduce the Radial Artery Occlusion Rate (from the Prospective and Randomized CRASOC I, II, and III Studies)

Vincent Dangoisse, Antoine Guédès, Patrick Chenu, Claude Hanet, Clara Albert, Valérie Robin, Laurence Tavier, Christine Dury, Olivier Piraux, Juliette Domange, Karine Jourdan, Benoit Bihin, Erwin Schroeder

Research output: Contribution to journalArticle

Abstract

The study sought to evaluate the benefit of the reduction in intensity and duration of the hemostasis obtained with the transradial (TR) Band compression device on the radial artery occlusion (RAO) rate. RAO is the most frequent complication of TR access for cardiac catheterization and limits future use of this safe route. Its occurrence must be minimized. Between 2009 and 2016, 3,616 TR accesses were randomized to TR Band hemostasis during 3 consecutive protocols: CRASOC I (Compression of Radial ArterieS without Occlusion): 13 versus 10 cc of air into the TR Band and for 4 hours of continuous compression; CRASOC II: 10 cc of air for 3 hours versus 2 hours of compression; and CRASOC III: 10 cc of air for 2 hours versus 1.5 hours of compression and virtual 4F introducer as default sheath (both arms). Radial artery patency was assessed by plethysmography at 24 hours, using Doppler for doubtful or negative plethysmography. The primary end point, 24 hours of RAO, was markedly reduced when hemostasis was soft (10 cc of air) and short (1.5 hours) and resulted in a 2.3% rate of RAO versus 9.4% for 13 cc, 4 hours. Hemostasis was obtained in 89% of patients with only 10 cc of air and in 97% of patients with less than the recommended 13 cc. About 8% of patients required more than the 1.5 hours of hemostasis time. In conclusion, short and soft hemostasis with the TR Band device leads to a low RAO rate.

Original languageEnglish
Pages (from-to)374-379
Number of pages6
JournalThe American journal of cardiology
Volume120
Issue number3
Early online date2017
DOIs
Publication statusPublished - 1 Aug 2017
Externally publishedYes

Fingerprint

Radial Artery
Percutaneous Coronary Intervention
Hemostasis
Coronary Angiography
Equipment and Supplies
Air
Plethysmography
Cardiac Catheterization

Keywords

  • Aged, 80 and over
  • Arterial Occlusive Diseases/epidemiology
  • Belgium/epidemiology
  • Coronary Angiography/adverse effects
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Hemostatic Techniques/instrumentation
  • Humans
  • Incidence
  • Male
  • Percutaneous Coronary Intervention/adverse effects
  • Prospective Studies
  • Radial Artery
  • Risk Factors
  • Time Factors

Cite this

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title = "Usefulness of a Gentle and Short Hemostasis Using the Transradial Band Device after Transradial Access for Percutaneous Coronary Angiography and Interventions to Reduce the Radial Artery Occlusion Rate (from the Prospective and Randomized CRASOC I, II, and III Studies)",
abstract = "The study sought to evaluate the benefit of the reduction in intensity and duration of the hemostasis obtained with the transradial (TR) Band compression device on the radial artery occlusion (RAO) rate. RAO is the most frequent complication of TR access for cardiac catheterization and limits future use of this safe route. Its occurrence must be minimized. Between 2009 and 2016, 3,616 TR accesses were randomized to TR Band hemostasis during 3 consecutive protocols: CRASOC I (Compression of Radial ArterieS without Occlusion): 13 versus 10 cc of air into the TR Band and for 4 hours of continuous compression; CRASOC II: 10 cc of air for 3 hours versus 2 hours of compression; and CRASOC III: 10 cc of air for 2 hours versus 1.5 hours of compression and virtual 4F introducer as default sheath (both arms). Radial artery patency was assessed by plethysmography at 24 hours, using Doppler for doubtful or negative plethysmography. The primary end point, 24 hours of RAO, was markedly reduced when hemostasis was soft (10 cc of air) and short (1.5 hours) and resulted in a 2.3{\%} rate of RAO versus 9.4{\%} for 13 cc, 4 hours. Hemostasis was obtained in 89{\%} of patients with only 10 cc of air and in 97{\%} of patients with less than the recommended 13 cc. About 8{\%} of patients required more than the 1.5 hours of hemostasis time. In conclusion, short and soft hemostasis with the TR Band device leads to a low RAO rate.",
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author = "Vincent Dangoisse and Antoine Gu{\'e}d{\`e}s and Patrick Chenu and Claude Hanet and Clara Albert and Val{\'e}rie Robin and Laurence Tavier and Christine Dury and Olivier Piraux and Juliette Domange and Karine Jourdan and Benoit Bihin and Erwin Schroeder",
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Usefulness of a Gentle and Short Hemostasis Using the Transradial Band Device after Transradial Access for Percutaneous Coronary Angiography and Interventions to Reduce the Radial Artery Occlusion Rate (from the Prospective and Randomized CRASOC I, II, and III Studies). / Dangoisse, Vincent; Guédès, Antoine; Chenu, Patrick; Hanet, Claude; Albert, Clara; Robin, Valérie; Tavier, Laurence; Dury, Christine; Piraux, Olivier; Domange, Juliette; Jourdan, Karine; Bihin, Benoit; Schroeder, Erwin.

In: The American journal of cardiology, Vol. 120, No. 3, 01.08.2017, p. 374-379.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Usefulness of a Gentle and Short Hemostasis Using the Transradial Band Device after Transradial Access for Percutaneous Coronary Angiography and Interventions to Reduce the Radial Artery Occlusion Rate (from the Prospective and Randomized CRASOC I, II, and III Studies)

AU - Dangoisse, Vincent

AU - Guédès, Antoine

AU - Chenu, Patrick

AU - Hanet, Claude

AU - Albert, Clara

AU - Robin, Valérie

AU - Tavier, Laurence

AU - Dury, Christine

AU - Piraux, Olivier

AU - Domange, Juliette

AU - Jourdan, Karine

AU - Bihin, Benoit

AU - Schroeder, Erwin

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - The study sought to evaluate the benefit of the reduction in intensity and duration of the hemostasis obtained with the transradial (TR) Band compression device on the radial artery occlusion (RAO) rate. RAO is the most frequent complication of TR access for cardiac catheterization and limits future use of this safe route. Its occurrence must be minimized. Between 2009 and 2016, 3,616 TR accesses were randomized to TR Band hemostasis during 3 consecutive protocols: CRASOC I (Compression of Radial ArterieS without Occlusion): 13 versus 10 cc of air into the TR Band and for 4 hours of continuous compression; CRASOC II: 10 cc of air for 3 hours versus 2 hours of compression; and CRASOC III: 10 cc of air for 2 hours versus 1.5 hours of compression and virtual 4F introducer as default sheath (both arms). Radial artery patency was assessed by plethysmography at 24 hours, using Doppler for doubtful or negative plethysmography. The primary end point, 24 hours of RAO, was markedly reduced when hemostasis was soft (10 cc of air) and short (1.5 hours) and resulted in a 2.3% rate of RAO versus 9.4% for 13 cc, 4 hours. Hemostasis was obtained in 89% of patients with only 10 cc of air and in 97% of patients with less than the recommended 13 cc. About 8% of patients required more than the 1.5 hours of hemostasis time. In conclusion, short and soft hemostasis with the TR Band device leads to a low RAO rate.

AB - The study sought to evaluate the benefit of the reduction in intensity and duration of the hemostasis obtained with the transradial (TR) Band compression device on the radial artery occlusion (RAO) rate. RAO is the most frequent complication of TR access for cardiac catheterization and limits future use of this safe route. Its occurrence must be minimized. Between 2009 and 2016, 3,616 TR accesses were randomized to TR Band hemostasis during 3 consecutive protocols: CRASOC I (Compression of Radial ArterieS without Occlusion): 13 versus 10 cc of air into the TR Band and for 4 hours of continuous compression; CRASOC II: 10 cc of air for 3 hours versus 2 hours of compression; and CRASOC III: 10 cc of air for 2 hours versus 1.5 hours of compression and virtual 4F introducer as default sheath (both arms). Radial artery patency was assessed by plethysmography at 24 hours, using Doppler for doubtful or negative plethysmography. The primary end point, 24 hours of RAO, was markedly reduced when hemostasis was soft (10 cc of air) and short (1.5 hours) and resulted in a 2.3% rate of RAO versus 9.4% for 13 cc, 4 hours. Hemostasis was obtained in 89% of patients with only 10 cc of air and in 97% of patients with less than the recommended 13 cc. About 8% of patients required more than the 1.5 hours of hemostasis time. In conclusion, short and soft hemostasis with the TR Band device leads to a low RAO rate.

KW - Aged, 80 and over

KW - Arterial Occlusive Diseases/epidemiology

KW - Belgium/epidemiology

KW - Coronary Angiography/adverse effects

KW - Equipment Design

KW - Female

KW - Follow-Up Studies

KW - Hemostatic Techniques/instrumentation

KW - Humans

KW - Incidence

KW - Male

KW - Percutaneous Coronary Intervention/adverse effects

KW - Prospective Studies

KW - Radial Artery

KW - Risk Factors

KW - Time Factors

UR - http://www.scopus.com/inward/record.url?scp=85020022219&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2017.04.037

DO - 10.1016/j.amjcard.2017.04.037

M3 - Article

VL - 120

SP - 374

EP - 379

JO - The American journal of cardiology

JF - The American journal of cardiology

SN - 0002-9149

IS - 3

ER -