Manual versus mechanical compression hemostasis approach after coronary angiography via snuffbox access

Abstract

Objective: Distal radial artery access or trans-snuffbox access (TSA) is a novel, safe, and feasible technique for coronary artery interventions wherein its vascular hemostasis is still concerned. So, this study aimed to compare two homeostasis methods comprising manual and mechanical compression approaches in patients undergoing coronary angiography (CAG) via TSA. Methods: In a prospective nonrandomized clinical trial, a total of 80 patients undergoing diagnostic CAG by TSA were divided into two equal groups: manual compression and mechanical compression (using radial TR band), the main end point of which was primary hemostasis time. Other variables were patient satisfaction, puncture site pain severity, hospitalization time, and local neurovascular complication during the 30-day follow-up. Results: The mean age of the patients was 57.1 +/- 8.0 years, with 40 of them (54.1) being male. The primary hemostasis time was significantly shorter in the manual compression approach 115.0 +/- 5.9 minutes with median 15 (9-20)] than in the TR band group 125.7 +/- 4.9 minutes with median 25 (20-30)] (p<0.001). No significant difference was noted in the patient's satisfaction and puncture site pain severity as well as hospitalization time between the two methods (p>0.050). The neurovascular complication, including hematoma, numbness, and dRA occlusion, rates had also no significant difference between the two groups (p>0.050). Conclusion: The manual compression approach on the puncture site reduces hemostasis time in patients undergoing CAG via TSA when compared with the mechanical compression method.