Optimal TR-band weaning strategy while minimizing vascular access site complications

Document Type

Conference Proceeding

Publication Date


Publication Title

J Am Coll Cardiol


Background: Transradial cardiac catheterization is increasing in the United States due to the advantages of less access site complications and patient preference. A compression device is most commonly used to achieve hemostasis following sheath removal, however the optimalweaning strategy to expedite TR-band removal whileminimizing access site complications has yet to be defined. The purpose of this study was to develop an optimal TR-Band weaning strategy while minimizing vascular accesssite complications of hematoma or radial artery occlusion. Methods: The trial was a randomized, prospective, single center study of 129 patients who underwent cardiac catheterization via the radial artery. Group A was an accelerated protocol in which weaning was initiated 20 minutes after sheath removal. Group B was an adjusted protocol, in which weaning was dependent on the amount of anti-platelet or anti-coagulation used. All patients underwent radial artery ultrasound to demonstrate arterial patency. Results: Baseline characteristics were similar in both groups, and PCI was performed in 36.7% of patients in Group A and 37.7% of patients in Group B. RAO occurred in 7.7% of patients overall, with no statistical difference between groups (Group A 5% versus Group B 10.1%, p-value = 0.337). Hematoma formation greater than 5 cm in diameter occurred in 4.6% of patients in the overall cohort, without statistical difference between groups (Group A 5.0% versus Group B 4.3%, p-value = 1). The TR-Band duration was signifcantly shorter in Group A compared to Group B (112.9 ± 50.7 versus 130.7 ± 51.1 in minutes, respectively, p-value = 0.013). Conclusion: We have demonstrated an accelerated weaning protocol without increased vascularsite complications of radial artery occlusion or hematoma formation, which could potentially reduce hospital stay in same-day procedures.





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