A Randomized Controlled Trial Comparing Elastic Compressive Dressing and the TR Band After Transradial Coronary Intervention

Abstract

Background: Transradial coronary intervention has been shown to be both safe and effective, with several benefits, such as limited access to site complications and earlier patient discharge. Radial compression devices, on the other hand, add to the total expense of the procedure and have not been adequately compared to traditional compressive dressings. The purpose of this study is to compare the safety and efficacy of elastic compressive dressing with gauze swabs and crepe bandages to balloon compression devices with the TR Band (Terumo) for maintaining radial hemostasis following cardiac procedures.

Method: A total of 402 patients were randomly assigned to receive either a TR band or an elastic compressive dressing for radial hemostasis following cardiac intervention in a prospective, partially blinded, randomized clinical study. The main outcome was the hemostasis time and the occurrence of hematoma. Patient satisfaction, postprocedure pain, vascular problems, and the cost of the compression device used were all secondary outcomes.

Results: The two groups had similar baseline characteristics and procedural data. The majority of patients (79%) were very satisfied with both hemostasis techniques. The elastic dressing group achieved hemostasis significantly faster than the TR band group (83.8 ± 142.8 min vs. 116.3 ± 122.7, p = 0.017). Significant differences in the incidence of hematoma (8% elastic dressing vs. 18.4% TR band, p = 0.003) and postprocedural pain (0.84 ± 1.2 elastic dressing vs. 1.39 ± 1.4 TR band, p ≤ 0.001) were observed. The incidence of early radial artery occlusion was higher in the elastic dressing group (7 patients) than in the TR band group (2 patients), although the difference was not statistically significant (p = 0.09). Finally, the TR band was significantly more expensive than the elastic dressing used in the trial.

Conclusion: Elastic compressive dressings are a safe, low-cost, and effective alternative to TR band. They decrease hemostasis time, enhance patient comfort, and reduce both the number and size of hematomas. When compared to the TR band, these dressings have a similar rate of radial artery patency at discharge.

Trial Registration: ClinicalTrials.gov identifier: NCT05409716