Straight From the Wrist – September 2011

A review of recent transradial study data
Adhir Shroff, M.D., MPH


September 26, 2011

Effect of Duration of Hemostatic Compression on Radial Artery Occlusion After Transradial Access

Samir B. Pancholy, et al; Catheter Cardiovascular Interventions. May 16, 2011. doi: 10.1002/ccd.22963.

Study design: 
• 400 patients undergoing TR-PCI randomized to either two or six hours of hemostatic compression using the TR band

• Patent hemostasis technique was utilized for both groups

Primary endpoint:
• Early (24 hours) and chronic (30 days) radial artery occlusion

• Less early and late radial artery occlusion in the two-hour group

• Occlusive compression was the only predictor of radial artery occlusion

Bottom line:
• Prolonged hemostatic compression is associated with a higher rate of radial artery occlusion

Operator Radiation Exposure During Percutaneous Coronary Procedures Through the Left or Right Radial Approach: The TALENT Dosimetric Substudy

Alessandro Sciahbasi, et al; Circulation Cardiovascular Interventions. 2011;4:00-00.

Study design:
• 390 patients randomized to right versus left radial access. Operators remained on the patient’s right side for all procedures

• Three operators were outfitted with five dosimeters (left wrist, shoulder, thorax outside the lead apron, thorax under the lead apron, and thyroid)

Primary endpoint :
• Radiation dose received at each site

• No significant differences in fluoroscopy time between groups

• There was no difference in radiation dose received at the thorax, thyroid and shoulder. No radiation dose detected under the apron for both approaches

• At the wrist, there was higher radiation dose received for the RRA (2.44±1.12 mSv) compared with the LRA (1±0.8 mSv, P_0.002)

Bottom line:   
• Radiation exposure is similar between either approach except at the wrist, where left radial artery access was associated with a lower received dose