Manual Versus Mechanical Compression of the Radial Artery After Transradial Coronary Angiography: The MEMORY Multicenter Randomized Trial
Dimitrios Petroglou, Matthaios Didagelos, Georgios Chalikias, Dimitrios Tziakas, Grigorios Tsigkas, Georgios Hahalis, Michael Koutouzis, Antonios Ntatsios, Ioannis Tsiafoutis, Michael Hamilos, Antonios Kouparanis, Nikolaos Konstantinidis, Georgios Sofidis, Samir B Pancholy, Haralambos Karvounis, Olivier Francois Bertrand, Antonios Ziakas, Dimitrios Petroglou, Matthaios Didagelos, Georgios Chalikias, Dimitrios Tziakas, Grigorios Tsigkas, Georgios Hahalis, Michael Koutouzis, Antonios Ntatsios, Ioannis Tsiafoutis, Michael Hamilos, Antonios Kouparanis, Nikolaos Konstantinidis, Georgios Sofidis, Samir B Pancholy, Haralambos Karvounis, Olivier Francois Bertrand, Antonios Ziakas
Abstract
Objectives: The aim of this study was to compare manual versus mechanical compression of the radial artery after coronary angiography via transradial access regarding radial artery occlusion (RAO), access-site bleeding complications, and duration of hemostasis.
Background: Hemostasis of the radial artery after sheath removal can be achieved either by manual compression at the puncture site or by using a mechanical hemostasis device. Because mechanical compression exerts a more stable, continuous pressure on the artery, it could be hypothesized that it is more effective compared with manual compression regarding hemostasis time, bleeding, and RAO risks.
Methods: A total of 589 patients undergoing diagnostic coronary angiography by transradial access with a 5-F sheath were randomized in a 1:1 ratio to receive either manual or mechanical patent hemostasis of the radial artery. Radial artery patency was evaluated by color duplex ultrasonography 24 h after the procedure. The primary endpoint was early RAO at 24 h. Secondary endpoints included access-site bleeding complications and duration of hemostasis.
Results: Thirty-six (12%) early RAOs occurred in the manual group, and 24 (8%) occurred in the mechanical group (p = 0.176). There were no significant differences between the 2 groups regarding access-site bleeding complications (hematoma, 52 [17%] vs. 50 [18%]; p = 0.749; bleedings, 8 [3%] vs. 9 [3%]; p = 1.000). Duration of hemostasis was significantly shorter in the manual group (22 ± 34 min vs. 119 ± 72 min with mechanical compression; p < 0.001).
Conclusions: Manual and mechanical compression resulted in similar rates of early RAO, although the total duration of hemostasis was significantly shorter in the manual group.
Keywords: angiography; angioplasty; compression device; hemostasis; transradial.
Copyright © 2018 American College of Cardiology Foundation. All rights reserved.
Source: PubMed