Prospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2021; 13(10): 574-584
Published online Oct 26, 2021. doi: 10.4330/wjc.v13.i10.574
Patent hemostasis of radial artery: Comparison of two methods
Vassileios Kyriakopoulos, Andrew Xanthopoulos, Michail Papamichalis, Spyridon Skoularigkis, Chara Tzavara, Emmanouil Papadakis, Sotirios Patsilinakos, Filippos Triposkiadis, John Skoularigis
Vassileios Kyriakopoulos, Emmanouil Papadakis, Sotirios Patsilinakos, Department of Cardiology, Konstantopoulio General Hospital, Athens 14233, Greece
Andrew Xanthopoulos, Michail Papamichalis, Spyridon Skoularigkis, Filippos Triposkiadis, John Skoularigis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Chara Tzavara, Department of Health, Medical School, University of Athens, Athens 11527, Greece
Author contributions: Kyriakopoulos V participated in design of the study, drafted the manuscript and was involved with data collection; Xanthopoulos A participated in design of the study, drafted the manuscript, and participated in oversight of the study; Papamichalis M drafted the manuscript and was involved with data collection; Skoularigkis S participated in design of the study, and was involved with data collection; Tzavara C participated in design of the study and performed statistical analysis; Papadakis E was involved with data collection and drafted the manuscript; Patsilinakos S participated in design and oversight of the study; Triposkiadis F participated in design of the study and drafted the manuscript; Skoularigis J participated in design and oversight of the study and drafted the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the hospital’s ethics review board.
Informed consent statement: Patients participating in the study provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Data sharing statement: No additional data are available
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Consultant Physician-Scientist, Department of Cardiology, University Hospital of Larissa, Mezourlo, PO Box 1425, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: April 21, 2021
Peer-review started: April 21, 2021
First decision: May 13, 2021
Revised: May 24, 2021
Accepted: July 15, 2021
Article in press: July 15, 2021
Published online: October 26, 2021
Processing time: 182 Days and 21.4 Hours
ARTICLE HIGHLIGHTS
Research background

Radial artery obstruction is a frequent complication of coronary angiography performed via transradial access. Maintaining circulatory anterograde flow in the radial artery during hemostasis (patent or nonobstructive hemostasis) reduces the risk of radial artery obstruction.

Research motivation

Simplified and easily applicable methods for successful patent hemostasis are currently lacking.

Research objectives

To determine which method, pulse oximeter vs the traditional radial artery palpation, is better to achieve patent hemostasis.

Research methods

This a prospective, single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July 2019. The exclusion criteria were: (1) Age of < 18 years; (2) History of radial artery disease; and (3) No palpable arterial pulse. Patients were randomly assigned to two groups. In the first group, radial artery flow was assessed by palpation of the artery during hemostasis (traditional method). In the second group, radial artery patency was estimated with a pulse oximeter. Two different compression devices were used for hemostasis (air chamber and pressure valve). The primary study endpoint was the successful achievement of patent hemostasis.

Research results

The two groups (pulse oximeter vs artery palpation) had no significant differences in age, sex, body mass index, risk factors, or comorbidities except for supraventricular arrhythmias. The percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group (82.2% vs 68.1%, P = 0.005). A lower percentage of patients with spasm was recorded in the pulse oximeter group (9.9% vs 19.0%, P = 0.024). Multivariate analysis found that the use of pulse oximeter (OR: 2.35, 95%CI: 1.34-4.13, P = 0.003) and advanced age (OR: 1.04, 95%CI: 1.01-1.07, P = 0.006), were independently associated with an increased probability of successful patent hemostasis. The type of hemostatic device did not affect patent hemostasis (P = 0.450).

Research conclusions

Patent hemostasis with the use of pulse oximeter is a simple, efficient, and safe method, and is worthy of further investigation.

Research perspectives

Larger randomized studies are required to consider its clinical implications.