Associazione Nazionale Medici Cardiologi Ospedalieri



Comparison between different transradial artery hemostasis protocols in Ligurian Cardiologies.

Lorenzo Puerari Pietra Ligure(Savona) – SC Cardiologia e UTIC. ASL 2 Savonese Po Ponente Santa Corona | Corona Maria Antonella Pietra Ligure(Savona) – SC Cardiologia e UTIC. ASL 2 Savonese Po Ponente Santa Corona

BACKGROUND Transradial artery access (TRA) for coronary angiography and percutaneous coronary intervention is associated with lower bleeding and vascular complications than transfemoral artery access. In our hospital, TRA is widely used and hemostasis is usually achieved using TRBand device. We used to remove the device in about 10 hours according to our protocol.

AIMS The aim of this study is to describe and compare different TRA hemostasis protocols in order to understand if a shorter protocol could be more effective.

METHODS This is an observational study performed in all Hospitals of our region (Liguria). All Cardiology Departments were included in this analysis. We requested to all to self-refer: a) which radial hemostasis device was used; b) which deflation protocol (DP) was used. c) If they usually report and analyze adverse events. Adverse events are described as: bleeding, hematoma, ecchymosis, skin damage, local infection, pseudoaneurysm, or artery occlusion.

RESULTS In Liguria there are 9 Cardiology Departments with Cath Lab (CL); 8 of them accepted to participate. All the Cath Labs use the TRBAND device but the deflation protocols are very different. 5 Cath Labs follows the DP suggested by the manufacturer. Only 2 CL adopted different DP if and higher dose of heparin was administered. Only one report bleedings or any delete in the DP. None analyze periodically the incidence of adverse events.

CONCLUSIONS There are different methods to achieve radial hemostasis furthermore with the same device different deflating protocols are used. Further studies are necessary to evaluate the best DP. Regular audits must be strongly suggested in all Cardiology Departments in order to monitorate and improve the adverse events.