Evaluation of the effects of compressive dressing after interventional procedures via radial approach

Fernando Canedo, Larissa Oliveira, M. Prudente, Patrícia Demuner, Débora Rodrigues, Guiulliano Gardenghi, A. Souza, Adriano Araújo
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Abstract

Background External compressive devices after radial puncture for cardiac catheterization and percutaneous coronary intervention aim at hemostasis, patient comfort, and safety. The objective of the study was to evaluate patients undergoing invasive coronary procedures by radial approach, in which a low-cost compressive dressing developed at the service was used, assessing its safety and the occurrence of complications. Methods Patients undergoing coronary angiography and percutaneous coronary intervention, evaluated at the time of removal of compressive dressing and after 7 days, by means of a questionnaire addressing comorbidities, clinical picture, procedure and compression time, physical assessment of hematoma and pain, and a vascular Doppler ultrasound to evaluate radial artery occlusion. Results A total of 144 patients were evaluated, 138 of whom were followed up within 7 days. Events did not differ among diagnostic and therapeutic procedures. In the immediate evaluation after removal of dressing, an incidence of 4.2% of radial artery occlusion was observed, with pain reported by 23.6% of patients, graded at 2.9±1.7 points in the Visual Analogue Scale (intensity of zero to ten), and no major bleeding. Hematoma occurred in one patient (0.9%), classified as type III according to the EASY criteria. In the 7-day evaluation, the incidence of radial artery occlusion was 2.2%, pain was reported in 11.1% of sample (intensity 1.8±0.8), and hematoma was evident in 3.5%. Conclusion The compressive dressing proved to be a safe procedure, with a low rate of complications and a low rate of local pain in patients undergoing invasive coronary procedures via radial approach.
评估桡动脉介入手术后加压敷料的效果
背景心导管检查和经皮冠状动脉介入治疗桡动脉穿刺后的外部加压装置旨在止血、提高患者舒适度和安全性。本研究的目的是对接受桡动脉穿刺冠状动脉介入手术的患者进行评估,其中使用了本机构开发的低成本加压敷料,并评估其安全性和并发症的发生率。方法 对接受冠状动脉造影术和经皮冠状动脉介入治疗的患者进行评估,在去除加压敷料时和 7 天后,通过问卷调查了解合并症、临床表现、手术过程和加压时间、血肿和疼痛的物理评估,以及评估桡动脉闭塞的血管多普勒超声。结果 共对 144 名患者进行了评估,其中 138 人在 7 天内接受了随访。诊断和治疗过程中发生的事件没有差异。在去除敷料后的即时评估中,观察到桡动脉闭塞的发生率为 4.2%,23.6% 的患者报告有疼痛,视觉模拟量表的评分为 2.9±1.7 分(强度为 0 至 10),没有大出血。一名患者(0.9%)出现了血肿,根据 EASY 标准被归类为 III 型。在 7 天的评估中,桡动脉闭塞的发生率为 2.2%,11.1% 的样本报告有疼痛(强度为 1.8±0.8),3.5% 的样本有明显血肿。结论 经桡动脉入路进行侵入性冠状动脉手术的患者中,加压敷料被证明是一种安全的手术,并发症发生率低,局部疼痛发生率低。
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