నైరూప్య

Impact of ipsilateral ulnar artery compression by the Turned-TR band technique on radial flow characteristic after percutaneous coronary procedures

Arrivi A, Bier N, Pucci G, Vaudo G, Boschetti E, Bock C, Casavecchia M, Bazzucchi M, Dominici M

Introduction: Radial Artery Occlusion (RAO) is a complication of the Transradial Approach (TRA). Ipsilateral ulnar artery compression was proposed as an effective technique to prevent acute RAO after TRA. In the present study, we evaluated the effects of ipsilateral ulnar artery compression obtained by the TR-band device on the ulnar site after classical hemostasis (“turnedTR band”) on radial flow characteristics after 24 h from the procedure. Methods: 131 patients were randomized 1:1 to receive 2 h of ipsilateral ulnar artery compression after classical hemostasis with the Turned TR-Band technique (TTR-B) vs no intervention (CG). Peak Systolic Velocity (PSV) and radial caliber reduction were evaluated by duplex ultrasonography at baseline and 24 h after each procedure. The 24 h occurrence of RAO was also ascertained. Results: None of the 131 patients (n=62 TTR-B, n=69 CG) showed procedure-related complications. No relevant difference in the percentage rate of changes in PSV vs baseline was observed between groups (-7% in the TTR-B, -9% in the CG, p=0.57). 4 patients randomized to TTR-B vs 9 patients in the CG group showed radial caliber reduction at the puncture site (OR 0.72; 95% C.I. 0.19-2.69, p=0.63). None of the patients in the TTR-B experienced RAO, whereas 1 case was recorded in the CG (0% vs 1.4%, p=0.55). Conclusions: The ipsilateral ulnar artery compression through the “TTR-Band” procedure is feasible and safe. The 24 h rate of vessel caliber reduction and RAO is not superior to conventional hemostasis, with a non-significant tendency toward lower reduction in PSV