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Randomized Controlled Trial
. 2018 Nov 1;92(5):844-851.
doi: 10.1002/ccd.27526. Epub 2018 Feb 16.

Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial

Adel Aminian  1 , Shigeru Saito  2 , Akihiko Takahashi  3 , Ivo Bernat  4 , Robert Lee Jobe  5 , Takashi Kajiya  6 , Ian C Gilchrist  7 , Yves Louvard  8 , Ferdinand Kiemeneij  9   10 , Niels van Royen  11 , Maarten van Leeuwen  11   12 , Seiji Yamazaki  13 , Takashi Matsukage  14 , Juan F Iglesias  15 , Sunil V Rao  16
Affiliations
Randomized Controlled Trial

Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial

Adel Aminian et al. Catheter Cardiovasc Interv. .

Abstract

Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients.

Methods and results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6% vs. 1.2%, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5% vs. 2.2%, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1%, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2% vs. 4.9%, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95% CI 1.008-1.136, P = 0.03).

Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.

Keywords: radial artery occlusion; slender sheath; transradial.

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Figures

Figure 1
Figure 1
Primary end‐point (RAO) according to study population and sheath type [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 2
Figure 2
Multivariate predictors of RAO
Figure 3
Figure 3
Rates of RAO according to sheath type and hemostasis time category in the total study population [Color figure can be viewed at http://wileyonlinelibrary.com]
See this image and copyright information in PMC

Comment in

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