Conventional vs Patent Hemostasis of the Radial Artery After Transradial Coronary Angiography: A Randomized Clinical Trial

Transradial coronary catheterization has already become popular in clinical practice. Radial artery occlusion (RAO) is an infrequent but discouraging complication of transradial access. Anterograde flow in the artery during hemostasis (patent hemostasis) may prevent arterial occlusion. This study aimed to compare conventional vs patent hemostasis after transradial coronary angiography regarding access site complications, especially RAO.
 
A prospective randomized, parallel, open-label clinical trial was conducted on consecutively adult patients scheduled to undergo a diagnostic or therapeutic transradial coronary procedure at Bu-Ali Sina and Mehregan hospitals (Qazvin, Iran) during a 3-month period between March 2021 and May 2021. Two hundred patients were divided randomly into conventional hemostasis and patent hemostasis groups. The incidence of RAO at discharge was evaluated in both groups as the primary endpoint, and other access site complications were considered the secondary endpoints.
 
The mean age of the patients was 61.60 ± 10.45 (range = 34-86) years, and the sex distribution (male/female) of the patients was 119/76. The baseline characteristics were similar in the 2 study groups. RAO at discharge was significantly less frequent in the patent hemostasis group (2 patients [2.02%]) than in the conventional hemostasis group (9 patients [9.37%]) (P = 0.02). Furthermore, demographic, clinical, and procedural variables were not associated with RAO.
 
Our study clearly demonstrated that patent hemostasis was highly effective in reducing RAO after transradial coronary catheterization. (Iranian Heart Journal 2024; 25(1): 56-65)