Comparing TR Band to Statseal in Conjunction With TR Band
Arterial Occlusion, Angina Pectoris, Cardiovascular Diseases
About this trial
This is an interventional health services research trial for Arterial Occlusion focused on measuring radial artery occlusion, time to hemostasis, radial artery, transradial catheterization, TR band, Statseal, hemostasis band, potassium ferrate, percutaneous coronary intervention
Eligibility Criteria
Inclusion Criteria:
- Patient undergoing diagnostic angiography or PCI via the radial artery
- Patients with a Barbeau test prior to the procedure showing pattern A,B,or
Exclusion Criteria:
- Use of a radial sheath larger than 6 Fr (a 7Fr-in-6 Glidesheath Slender ® is allowed).
- Use of an anticoagulant other than unfractionated heparin or bivalirudin.
- Any anticipated need for continued anticoagulation post-catheterization. Glycoprotein inhibitors are acceptable.
- Any active treatment with oral anticoagulants continued during course of procedure.
- Presence of arteriovenous dialysis fistula in the ipsilateral arm.
- Any physical deformity or trauma / injury of either wrist that would prevent proper placement or function of the hemostasis band.
- Raynaud's syndrome or known peripheral vascular disease of the forearm.
- Mental incompetence or inability to follow the instructions to complete the study.
- History or presence of Radial Artery Occlusion.
- Barbeau test showing Pattern D.
- Patients undergoing catheterization from the femoral or ulnar artery approach.
- Cardiogenic shock or any clinical instability as assessed by the physician performing the procedure.
Sites / Locations
- Veteran Affairs Long Beach
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
TR Band Only
Statseal with TR Band
TR Band: Patients randomly assigned to the control group will have a TR band applied over the arteriotomy site and inflated with 15-18ml of air. After aspirating and clearing the contents of the sheath, the radial sheath will be removed. The TR band will be deflated until bleeding occurs, and 2 ml of air will be reintroduced to provide hemostasis. Patent hemostasis will be documented with plethysmography and oximetry as described below within 5 minutes after band application and removal, and within 30 min of discharge or after 24 hours. The TR band will be left inflated and in place for 2 hours following the procedure for all patients (regardless of diagnostic or PCI procedure), after which deflation attempts will commence.
StatSeal: Patients randomly assigned to the experimental group will have a Statseal Advance (SSA) disc applied after withdrawing the radial sheath 2-4 cm. A Tegaderm dressing will be applied to secure the disc position. The TR band will be applied over the SSA disc with the center of the balloon (the green dot) over the center of the SSA disc. The TR band will be inflated with 8cc of air (which is typically occlusive pressure), and the sheath removed. No deflation will occur immediately. After 20 minutes of pressure, 3 cc of air will be removed from the TR band. After an additional 20 minutes (40 minutes after procedure), the TR band will be completely deflated, and the TR band left in place. After an additional 20 minutes (60 minutes after procedure) the TR band will be removed.