Randomized clinical study on radial artery compression time after elective coronary angiography.
Maria Aparecida de Carvalho Campos, Claudia Maria Rodrigues Alves, Miriam Harumi Tsunemi and 2 others
PMID 30517575WHAT IT FOUND
Shorter gauze compression after transradial angiography showed no clear difference in hemostasis or immediate artery complications versus longer compression, but more patients in the shorter group needed extra compression at the first check.
Key findings
01The main outcomes did not differ significantly between the assigned compression times for hemostasis, immediate complications, or late radial artery occlusion.
02At the first scheduled check, hemostasis was achieved in 116 of 152 patients in the 30-minute group and 128 of 151 patients in the 60-minute group (p=0.06).
03Immediate radial artery occlusion occurred in 20 of 152 patients in the 30-minute group and 18 of 151 patients in the 60-minute group (p=0.75).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one interventional cardiology unit, so the result may not apply to services with different patient mix, sheath sizes, or compression supplies. Patients and staff knew which compression time was assigned, because the dressing time was visible, so bleeding checks and tightening could have been influenced by expectations. Only patients undergoing elective diagnostic transradial catheterization were included, not those who had immediate percutaneous coronary intervention, so it says little about higher-risk treatment procedures. The groups were not identical: body mass index was higher in the 30-minute group, 27.7 kg/m2, than in the 60-minute group, 26.4 kg/m2 (p=0.02), which can affect puncture-site complications. Only 262 of 303 patients returned for the 30-day check, so late complications were assessed in a subset. The gauze dressing rarely produced patent hemostasis: 12 of 152 patients in the 30-minute group and 16 of 151 patients in the 60-minute group had patent hemostasis after placement.
The easy way to misread this
Do not conclude that 30-minute compression is proven safer, faster, or able to reduce hospital stay. The main outcomes did not differ significantly, and more patients in that group needed extra compression after the first check.