Radial artery hemostatis: earlier practice, actualities
█ Review
DOI: 10.26430/CHUNGARICA.2023.53.1.20
Authors:
Kulyassa Péter Márton1, Németh Balázs Tamás1, Ehrenberger Réka1,
Ruzsa Zoltán2, Szűk Tibor3, Fülöp Gábor Áron1,
Becker Dávid1, Merkely Béla1, Édes István Ferenc1
1Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
2Szegedi Tudományegyetem, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Szeged
3Debreceni Egyetem, Kardiológiai és Szívsebészeti Klinika, Debrecen
Levelezési cím:
Dr. Kulyassa Péter Márton, e-mail: peter.kulyassa@gmail.com
Summary
At the dawn of interventional cardiology, transfemoral access served as first choice access site. With the development of the interventional devices, transradial access became more favourable. The reasons include the reduced mortality rate and burden of post-procedural bleeding, early patient mobilization, and lower patient related treatment costs. Severe complication is the occlusion of the radial artery, which can cause ischemic symptoms in patients with non-intact palmar circulation. To avoid this, shorter manual compression time, and the utilization of patent hemostasis are validated methods. At patent hemostasis, anterograde flow through the radial artery is monitorized and assured during continuous manual compression. The pre-procedural non-invasive tests of the wrist arteries are to assess if the puncture of the radial artery is safe. The novel facilitated hemostasis devices are helping to shorten the time of manual compression. The two main types are the chitosan and potassium-ferrate covered devices. The puncture of distal radial artery site known as „snuffbox” became more and more used in the last few years in western medicine. In the available evidence less radial artery occlusion was observed and if the occlusion still occurs, it won’t compromise the palmar circulation. With the utilization of vascular ultrasound, the puncture technique is safe. The need for further optimalization of the elements of the radial cocktail is demanding more randomized controlled clinical trials. This also applies for longer term data of novel facilitated hemostatic devices.
ISSUE: CARDIOLOGIA HUNGARICA | 2023 | VOLUME 53, ISSUE 1
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