Manual Versus Mechanical Compression of the Radial Artery After Transradial Coronary Angiography: The MEMORY Multicenter Randomized Trial

• Published in: JACC. Cardiovascular interventions 2018-06, Vol.11 (11), p.1050-1058
• Main Authors: Petroglou, Dimitrios, Didagelos, Matthaios, Chalikias, Georgios, Tziakas, Dimitrios, Tsigkas, Grigorios, Hahalis, Georgios, Koutouzis, Michael, Ntatsios, Antonios, Tsiafoutis, Ioannis, Hamilos, Michael, Kouparanis, Antonios, Konstantinidis, Nikolaos, Sofidis, Georgios, Pancholy, Samir B, Karvounis, Haralambos, Bertrand, Olivier Francois, Ziakas, Antonios
• Format: Article
• Language: English
• ISSN: 1876-7605
• DOI: 10.1016/j.jcin.2018.03.042

The aim of this study was to compare manual versus mechanical compression of the radial artery after coronary angiography via transradial access regarding radial artery occlusion (RAO), access-site bleeding complications, and duration of hemostasis. Hemostasis of the radial artery after sheath removal can be achieved either by manual compression at the puncture site or by using a mechanical hemostasis device. Because mechanical compression exerts a more stable, continuous pressure on the artery, it could be hypothesized that it is more effective compared with manual compression regarding hemostasis time, bleeding, and RAO risks. A total of 589 patients undergoing diagnostic coronary angiography by transradial access with a 5-F sheath were randomized in a 1:1 ratio to receive either manual or mechanical patent hemostasis of the radial artery. Radial artery patency was evaluated by color duplex ultrasonography 24 h after the procedure. The primary endpoint was early RAO at 24 h. Secondary endpoints included access-site bleeding complications and duration of hemostasis. Thirty-six (12%) early RAOs occurred in the manual group, and 24 (8%) occurred in the mechanical group (p = 0.176). There were no significant differences between the 2 groups regarding access-site bleeding complications (hematoma, 52 [17%] vs. 50 [18%]; p = 0.749; bleedings, 8 [3%] vs. 9 [3%]; p = 1.000). Duration of hemostasis was significantly shorter in the manual group (22 ± 34 min vs. 119 ± 72 min with mechanical compression; p < 0.001). Manual and mechanical compression resulted in similar rates of early RAO, although the total duration of hemostasis was significantly shorter in the manual group.