Abstract：
Protocols for hemostasis after trans-radial approach (TRA) vary depending on the institute as there is no established evidence-based protocol. This study aimed to investigate the clinical implications of radial compression protocols. Consecutive patients who underwent outpatient invasive catheter angiography before and after April 2018 were treated with traditional and new protocols, respectively. Using the same hemostasis band, in the conventional protocol, fixed amount of air was removed soon after the procedure, 2 h later, and 3 h later, whereas the air was removed as much as possible every 30 min in the new protocol. A total of 1842 patients (71 ± 10 years old, 77% male) were included. Compared with the traditional protocol group (n = 1001), the new protocol group (n = 841) had a significantly lower rate of dual antiplatelet therapy (35% and 24% in the traditional and new groups, respectively, p < 0.001). The time required for complete hemostasis was approximately one-third with the new protocol (190 ± 16 and 66 ± 32 min, p < 0.001) with no clinically relevant bleeding. The incidence of radial artery occlusion (RAO) was 9.8% and 0.9% in the traditional and new protocol groups, respectively (p < 0.001). After adjusting for covariates, the new protocol was associated with a reduced risk of RAO (odds ratio 0.10, p < 0.001) and a shorter hemostasis time (odds ratio 0.01, p < 0.001). The new protocol for hemostasis after TRA was strongly associated with a shorter hemostasis time and a lower rate of RAO.
摘要：
经桡动脉途径（TRA）后的止血方案因机构而异，因为没有建立的循证方案。本研究旨在探讨放射状压缩方案的临床意义。2018年4月前后连续接受门诊有创导管血管造影的患者接受传统和新方案治疗。分别。使用相同的止血带，在常规协议中，固定量的空气在手术后不久被去除，2小时后，3小时后，而在新方案中，每30分钟尽可能多地去除空气。共1842例患者(71±10岁,77%的男性）被包括在内。与传统协议组(n=1001)相比，新方案组（n=841）的双重抗血小板治疗率明显较低（传统组和新组分别为35%和24%，分别,p<0.001)。使用新方案，完全止血所需的时间约为三分之一（190±16和66±32分钟，p<0.001），无临床相关出血。在传统和新方案组中，桡动脉闭塞（RAO）的发生率分别为9.8％和0.9％。分别(p<0.001)。在调整协变量后，新方案与降低RAO风险(比值比0.10,p<0.001)和缩短止血时间(比值比0.01,p<0.001)相关.TRA后止血的新方案与较短的止血时间和较低的RAO率密切相关。
