Benefits of pressure-controlled hemostasis for transradial vascular access: a randomized controlled trial

Abstract

BACKGROUND: Transradial vascular access is widely used due to advantages such as facile hemostasis and reduced bed rest time. Accordingly, several hemostatic devices have been introduced for transradial vascular access. However, the pain caused by hemostatic compression has not yet been resolved. The objective of this study was to determine the optimal compression pressure to minimize pain at the hemostasis site without increasing complications after transradial catheterization. METHODS: A total of 86 patients who underwent transradial catheterization from November 2014 to March 2015 were prospectively enrolled in this study. In group I (N.=42), the radial arteries were compressed by adjusting the air volume to reach systolic blood pressure plus 20 mmHg. For group II (N.=44), "conventional hemostasis" was performed by injecting a fixed volume (15 mL) of air into the air bag of the TR band. Complications, including pain, rebleeding, hematoma, and radial artery occlusion, were compared between the two groups. In addition, the pain level at the hemostasis site was assessed using a visual analog scale. RESULTS: The visual analog scale of group I was significantly lower than that of group II (1.548 +/- 1.549 vs. 2.466 +/- 1.682, P=0.01 at application; 1.202 +/- 1.700 vs. 2.818 +/- 2.060, P<0.001 at removal). The other complications were not significantly different between the two groups. CONCLUSIONS: Compared to conventional hemostasis, pressure-controlled hemostasis with systolic blood pressure plus 20 mmHg significantly reduced pain at the hemostasis site after transradial vascular access without increasing the incidence of other complications.