Assessment of Radial Artery Complications Whilst Achieving Rapid Haemostasis

Launched by LIVERPOOL HEART AND CHEST HOSPITAL NHS FOUNDATION TRUST · Jun 30, 2020

Keywords

ClinConnect Summary

Radial access for percutaneous cardiac procedures is the preferred method used by most interventional cardiologists. This method has proven to have the least complications and a much quicker patient's recovery time, compared to other access sites (e.g. femoral or brachial). Following sheath removal, a dressing is applied on the skin at the access site. Dressing currently in use include:

1. Conventional absorbent - an absorbent sterile adhesive dressing. This is our current, standard care.
2. Haemostatic - a sterile mineral-based absorbent dressing that aids clotting. It is not currently us...

Gender

ALL

Eligibility criteria

• Pre-Cath Lab Inclusion Criterion:
• • Patients scheduled for angiographic procedure with proposed radial access, regardless of their gender identity, ethnicity and religious belief
• Pre-Cath Lab Exclusion Criteria:
• • \< 18 years of age
• • Planned bilateral radial access
• • Any haematoma (\> 5 cm in its longest dimension) at planned puncture site prior to radial sheath insertion
• • Established diagnosis of any haematologic disorder or genetic defect predisposing to bleeding
• • Patients with International Normalised Ratio (INR) \> 2.5 prior to the scheduled angiographic procedure
• • Inability to perform adequate consent: communication issues (e.g. mental capacity); inadequate time for the participant to read and consider trial; unscheduled Urgent or Emergency procedures i.e. PPCI
• • Patients who are scheduled to be transferred to other hospitals ("treat and return") before haemostasis is achieved.
• • Electronic Patient Record technical failure leading to an inability to record participants' care
• In-Cath Lab Inclusion Criterion:
• • Single radial sheath in situ with planned removal in lab
• In-Cath Lab Exclusion Criteria:
• • Sheath removal after 17:00 hrs
• • Patient leaving lab with radial sheath in situ
• • Trans-ulnar procedure
• • Distal (snuffbox) trans-radial procedure
• • Any puncture-related haematoma (\> 5cm in its longest dimension) prior to radial sheath removal
• • Randomisation system not available
• • Dressings of both types not available
• • A change in patient's clinical condition during procedure deemed by the operator sufficient to exclude from the trial
• • Procedural complication requiring procedure termination