Comparing TR Band to Statseal in Conjunction With TR Band II (Statseal II)
Arterial Occlusion, Cardiovascular Diseases, Atherosclerosis
About this trial
This is an interventional treatment trial for Arterial Occlusion focused on measuring Radial Artery Occlusion, Time to Hemostasis, Statseal, TR Band, cardiac catheterization, transradial catheterization, 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 C.
Exclusion Criteria: any one of the following...
- Use of a radial sheath larger than 6 Fr (a 7Fr-in-6 Glidesheath Slender ® is allowed).
- Use of a hemostasis method or device besides the TR Band.
- Patients undergoing catheterization from the femoral, brachial, ulnar, or distal radial (snuffbox) artery approach.
- Use of an anticoagulant other than unfractionated heparin or bivalirudin.
- Any use of glycoprotein inhibitors or cangrelor.
- Use of sheathless guides.
- Any anticipated need for continued anticoagulation post-catheterization, including extended bivalirudin infusion.
- 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.
- Inability of the patient to personally consent for the study. (no surrogate consent)
- History or presence of Radial Artery Occlusion.
- Barbeau test showing Pattern D.
- 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
Patients 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 60 minutes following the procedure for all patients (regardless of diagnostic or PCI procedure), after which full deflation attempts will commence.
Patients will have a Statseal Advance RAD (SS) 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 SS disc with the center of the balloon (the green dot) over the center of the SS 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 40 minutes (60 minutes after procedure), the TR band will be completely deflated.