Hemostatic effect between bandage compression and balloon compression hemostat in patients undergoing transradial coronary intervention: a single-center, prospective, randomized controlled study

  AIM  To compare the hemostatic effect between compression and balloon compression hemostat in patients undergoing transradial coronary intervention.

  METHODS  A total of 300 consecutive patients from January 1, 2018 to March 22, 2018 were randomized to 2 groups, 150 patients in bandage compression group and 150 patients in balloon compression hemostat group. The primary study endpoint was in-hospital vascular related complication, including operative area bleeding, skin ecchymosis of wrist and forearm, upper limb numbness, upper limb pain, upper extremity edema, cyanosis of hand, tension blister, vagus reflex, radial artery occlusion and arteriovenous fistula. The secondary study endpoint was the cost of two groups of hemostasis methods.

  RESULTS  There were no significant differences in sex, age, smoking history, hypertension history and admission diagnosis between the two groups (P > 0.05). The incidence of vascular related complication as the primary endpoint was similar between the bandage compression group versus the balloon compression hemostat group (8.67% vs. 7.33%, Non-inferiority test P < 0.01). There were no significant differences in operative area bleeding, skin ecchymosis of wrist and forearm, upper limb numbness, upper limb pain, upper extremity edema, cyanosis of hand, tension blister, vagus reflex, radial artery occlusion and arteriovenous fistula between the two groups (all P > 0.05). In the balloon compression hemostat group, 4 patients (2.7%) occurred hemorrhage and hematoma, which were converted to bandage compression. The proportion of upper limb suspension treatment increased in the group of balloon compression hemostat, but there was no significant difference between the two groups (1.3% vs. 0.7%, P = 1.00). The cost of balloon pressure hemostat group was significantly higher than the bandage compression group (254 ± 0) yuan vs. (25 ± 12) yuan, P < 0.01.

  CONCLUSION  The advantage of bandage compression is high potency-price ratio. The effect of bandage compression in preventing vascular related complication is not worsen than balloon compression hemostat.