Relation of radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression

Background: Trans-radial percutaneous coronary intervention (PCI) in cardiac procedures accesses coronary arteries through the wrist's radial artery. Post-PCI, hemostatic compression on the radial artery prevents bleeding and aids healing. Radial artery occlusion (RAO), a possible complication, involves blockage of the radial artery. This study aimed to assess the relationship between radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression. Methods: This prospective observational study was conducted in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, spanning from September 2018 to August 2019. The study enrolled 140 patients who underwent percutaneous coronary intervention (PCI) through the trans-radial approach (TRA), randomly assigned to two groups: Group I (2-hour hemostatic compression after PCI) and Group II (6-hour hemostatic compression post-procedure). Data analysis was performed using SPSS version 23.0. Results: In this study, early radial artery occlusion was observed in 4.3% of patients in group I and 12.8% in group II (P=0.04), while late radial artery occlusion occurred in 2.8% of patients in group I and 11.4% in group II, with a statistically significant difference (P=0.04). Multivariate logistic regression analysis identified a 6-hour hemostatic compression duration (P=0.01), post-procedural nitroglycerine use (P=0.03), and procedure time (P=0.03) as predictors of radial artery occlusion. Conclusions: Reduced hemostatic compression duration is linked to a decreased occurrence of both early and late radial artery occlusion following trans-radial intervention.