Comparison of Hemostasis Times With a Kaolin-Based Hemostatic Pad (QuikClot Radial) vs Mechanical Compression (TR Band) Following Transradial Access: A Pilot Prospective Study

J Invasive Cardiol. 2017 Oct;29(10):328-334. Epub 2017 Aug 15.

Abstract

Background: Hemostasis following transradial access (TRA) is usually achieved by mechanical compression. We investigated use of the QuikClot Radial hemostasis pad (Z-Medica) compared with the TR Band (Terumo Medical) to shorten hemostasis after TRA.

Methods: Thirty patients undergoing TRA coronary angiography and/or percutaneous coronary intervention were randomized into three cohorts post TRA: 10 patients received mechanical compression with the TR Band, 10 patients received 30 min of compression with the QuikClot Radial pad, and 10 patients received 60 min of compression with the QuikClot Radial pad. Times to hemostasis and access-site complications were recorded. Radial artery patency was evaluated 1 hour after hemostasis by the reverse Barbeau's test.

Results: There were no differences in patient characteristics, mean dose of heparin (7117 ± 1054 IU), or mean activated clotting time value (210 ± 50 sec) at the end of procedure among the three groups. Successful hemostasis was achieved in 100% of patients with both the 30-min and 60-min compression groups using the QuikClot pad. Hemostasis failure occurred in 50% of patients when the TR Band was initially weaned at the protocol-driven time (40 min after sheath removal). Mean compression time for hemostasis with the TR Band was 149.4 min compared with 30.7 min and 60.9 min for the 30-min and 60-min QuikClot groups, respectively. No radial artery occlusion occurred in any subject at the end of the study.

Conclusions: Use of the QuikClot Radial pad following TRA in this pilot trial significantly shortened hemostasis times when compared with the TR Band, with no increased complications noted.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catheterization, Peripheral* / adverse effects
  • Catheterization, Peripheral* / methods
  • Compression Bandages*
  • Coronary Angiography / methods
  • Female
  • Hemostasis, Surgical* / instrumentation
  • Hemostasis, Surgical* / methods
  • Hemostatics / therapeutic use
  • Humans
  • Kaolin / therapeutic use*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Outcome and Process Assessment, Health Care
  • Percutaneous Coronary Intervention / methods
  • Pilot Projects
  • Radial Artery / surgery*
  • Time Factors
  • Vascular Patency

Substances

  • Hemostatics
  • Kaolin