Yunis Daralammouri, Fateh Awwad, Murad Azamtta, Hamza A. Salim, Ghaith M. Zakaria, Basel Musmar, Yahya S. Mosleh, Aidah Alkaissi
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引用次数: 0
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.
背景：经桡动脉冠状动脉介入治疗已被证明是安全有效的，并具有一些优点，如减少对部位并发症的接触和患者早期出院。另一方面，径向压缩装置增加了手术的总费用，并且与传统的压缩敷料相比还没有得到充分的比较。本研究的目的是比较纱布拭子和绉带弹性压缩敷料与TR带（Terumo）球囊压缩装置在心脏手术后维持桡骨止血的安全性和有效性。方法：在一项前瞻性、部分盲法、随机临床研究中，共有402例患者被随机分配接受TR带或弹性压缩敷料用于心脏介入治疗后桡动脉止血。主要观察指标为止血时间和血肿发生情况。患者满意度、术后疼痛、血管问题和所用压迫装置的成本都是次要结果。结果：两组具有相似的基线特征和手术资料。大多数患者（79%）对两种止血技术都非常满意。弹性敷料组止血速度明显快于TR带组（83.8±142.8 min vs 116.3±122.7 min, p = 0.017）。血肿发生率（弹性敷料8% vs. TR带18.4%,p = 0.003）和术后疼痛发生率（弹性敷料0.84±1.2 vs. TR带1.39±1.4,p≤0.001）差异有统计学意义。弹性敷料组（7例）早期桡动脉闭塞发生率高于TR带组（2例），但差异无统计学意义（p = 0.09）。最后，TR带明显比试验中使用的弹性敷料昂贵。结论：弹性压缩敷料是一种安全、廉价、有效的替代TR带的方法。它们缩短了止血时间，提高了患者的舒适度，减少了血肿的数量和大小。与TR带相比，这些敷料在出院时具有相似的桡动脉通畅率。试验注册：ClinicalTrials.gov标识符：NCT05409716
期刊介绍：
Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including:
Acute coronary syndrome
Coronary disease
Congenital heart diseases
Myocardial infarction
Peripheral arterial disease
Valvular heart disease
Cardiac hemodynamics and physiology
Haemostasis and thrombosis
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