Compressive Elastic Dressing Versus TR Band (Band Vs Gauze)

Comparison Between Compressive Elastic Dressing and Hemostatic TR Band Following Cardiac Intervention Utilizing the Radial Technique: A Randomized Controlled Trial

Radial approach is widely established in cardiac diagnostic and therapeutic treatments. It has been shown to decrease bleeding, vascular problems, and mortality rates when compared to the femoral approach. It also offers better comfort to patients through early mobility and lowers hospital expenses. Previously, there were no specific devices for radial artery hemostasis. Many different types of dressings were used in various hospitals with no standardization. This raises the question of whether specific devices surpass dressings in terms of patient comfort, time required to maintain hemostasis, and vascular complications. The primary goal of this study was to examine the effectiveness of compression dressings and hemostatic wristbands on patients undergoing cardiac procedures via radial approach in terms of patient comfort, time required to maintain hemostasis, and vascular problems. The hemostatic wristband TR BandR (Terumo Corporation, Tokyo, Japan) was utilized in one group, while compressive elastic dressing, standardized as 13 threads gauze overlapped, opened, longitudinally pleated once and wrapped, making a 5-cm long cylinder, 1-cm in height, was used in the other.

Coronary Artery Disease, Myocardial Infarction, Angina, Unstable, Angina, Stable, Acute Coronary Syndrome, STEMI, NSTEMI, Ischemic Heart Disease, Atherosclerotic Cardiovascular Disease, Chest Pain, Non ST Elevation Myocardial Infarction

Radial approach, Wristband, TR Band, compressive dressing, cardiac catheterization, radial artery, safeguard, randomized controlled trial

Patients enrolled to the study were randomized into TR Band or compressive dressing groups. Care providers operated on patients and investigators collected their data during and after the operation. The independent variable - Hemostasis technique (TR Band or compressive dressing ) - was coded into X or Z groups, then data was sent to the outcomes assessor.

Patients who received compressive elastic dressing as a hemostasis technique after coronary angiography using radial approach.

Patients who received wristband TR Band as a hemostasis technique after coronary angiography using radial approach.

Following cardiac procedure using radial approach, compressive elastic dressing, standardized as 13 threads gauze overlapped, opened, longitudinally pleated once and wrapped, making a 5-cm long cylinder, 1-cm in height, fixed with elastic crepe bandage was used to achieve hemostasis.

Following cardiac procedure using radial approach, hemostatic wristband TR BandR (Terumo Corporation, Tokyo, Japan) was utilized was used to achieve hemostasis.

The time from the placement of the hemostatic Wristband or Compressive dressing until its removal (when there's no blood oozing after removal), measured by minutes.

Radial artery patency was checked by evaluating radial pulse, capillary refill, hand color, temperature, and assessing the puncture site and hand for any hematoma or bleeding. In the event of an access site hematoma or any other ischemia sign, the patient will be sent to the radiology department for further assessment with radial artery Doppler.

Assessed by numerical rating scale (NRS) for pain, which is an 11 point subjective scale (0-10) where 0 refers for no pain, 1-3 for mild pain, 4-6 for moderate pain and 7-10 for severe pain.

Assessed by Likert scale for satisfaction , which is a 5 point subjective scale (1-5) where 1 refers for Not at all satisfied , 2 for slightly satisfied , 3 for moderately satisfied, 4 for Very satisfied and 5 for Extremely satisfied.

Inclusion Criteria: Age > 18 years Patients who agree to participate in the study and sign the consent form. Patients with an indication for coronary catheterization Clinically stable patients Patients with palpable pulses on at least one of the radial arteries. Exclusion Criteria: Patients who are hemodynamically unstable (systolic blood pressure less 90mmhg) Patients with radial AV shunt for hemodialysis Patients with previous CABG using radial artery Patients with Renaud phenomenon or lymphedema Patients who had vascular problems at the puncture site before the hemostasis process started. Failure to obtain radial access