EP36 Optimal technique to ensure patent haemostasis in trans-radial access

• Published in: Journal of neurointerventional surgery Vol. 13; no. Suppl 2; p. A14
• Main Authors: Hashim, Z, Davies, J, Sammut, SJ, Wells, K, Qayyum, N, Jadun, CK
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.08.2021
• Subjects: Ultrasonic imaging
• ISSN: 1759-8478; 1759-8486
• DOI: 10.1136/neurintsurg-2021-ESMINT.35

IntroductionRadial artery occlusion is one of the significant (but thankfully rare) complications of Trans-radial access (TRA). Though it is usually asymptomatic, radial artery occlusion hinders it being used in the future for interventional procedures. Hence, attempts should be made to avoid this by ensuring patent haemostasis post procedure.ObjectiveTo determine optimal way to ensure patent haemostasis.MethodsPatients divided into two groups: Cohort A: After every TRA intervention, patent haemostasis checked with ultrasound and with reverse Barbeau’s test.Cohort B: After every TRA Trans-radial band inflated only by 2 ml air extra beyond minimum air needed to stop bleeding from access site.Radial artery patency was checked prior to patient discharge from hospital.ResultsEach cohort had 30 patients in it.Reverse Barbeau’s test and ultrasound assessment were equally accurate at checking for patent haemostasis, though ultrasound did take longer and would need an operator skilled in using ultrasound.An important observation on ultrasound was that when radial band was over–inflated, the distal radial artery was collapsed, hence showing importance of not over–inflating the band.No cases of radial artery occlusion seen in either cohort.ConclusionAll the above three techniques were equally effective in ensuring patent haemostasis post TRA, though the cohort B technique was felt to be the quickest and simplest to perform.ReferencePancholy S, Coppola J, Patel T, Roke-Thomas M. Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization. Catheter Cardiovasc Interv 2008 Sep 1;72(3):335–340. doi: 10.1002/ccd.21639. PMID: 18726956.DisclosureNothing to disclose