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document
Efficacy and safety of transient ulnar artery compression to recanalize acute radial artery occlusion after transradial catheterization . Radial artery occlusion ( RAO ) can result from transradial catheterization . We compared the incidence of RAO with 2 heparin dosage regimens after transradial coronary angiography , and we evaluated the efficacy and safety of transient homolateral ulnar artery compression to achieve acute radial artery recanalization . Patients referred for coronary angiography were randomized to very-low-dose heparin ( 2,000 IU ) or low-dose heparin ( 5,000 IU ) . On sheath removal , hemostasis was obtained using the TR band with a plethysmography-guided patent hemostasis technique . In the case of RAO as assessed by duplex ultrasonography 3 to 4 hours after hemostasis , immediate 1-hour ulnar artery compression was applied . Hematomas > 15 cm ( 2 ) were also assessed . We randomized 465 patients , 222 in the 2,000-IU group and 243 in the 5,000-IU group . The baseline and procedural characteristics were comparable in both groups . The incidence of initial RAO was 5.9 % in the 2,000-IU group and 2.9 % in the 5,000-IU group ( p = 0.17 ) , with a compression time of 2.10 ± 0.78 hours and 2.25 ± 0.82 hours , respectively ( p = 0.051 ) . After ulnar artery compression , the final incidence of RAO was 4.1 % in the 2,000-IU group and 0.8 % in the 5,000-IU group ( p = 0.03 ) . The incidence of local hematoma was 2.3 % and 3.7 % in the 2,000- and 5,000-IU groups , respectively ( p = 0.42 ) . In conclusion , acute RAO after transradial catheterization can be recanalized by early 1-hour homolateral ulnar artery compression . This simple nonpharmacologic method was effective and safe in patients with very-low- and low-dose heparin . Nevertheless , the incidence of final RAO remained significantly lower after a higher anticoagulation level .
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Intervention_Physical
transient ulnar artery compression
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Intervention_Pharmacological
very-low-dose heparin
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Intervention_Pharmacological
low-dose heparin
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Outcome_Physical
incidence of initial RAO
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Participant_Condition
Patients referred for coronary angiography
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Participant_Sample-size
465 patients