Nismat Javed1, Jahanzeb Malik2,

1Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan, 2Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan

Novel hemostasis strategies, including the Prelude SYNC DISTAL radial compression device (PSD; Merit Medical Systems, Inc., South Jordan, UT) for distal radial artery access (DSA), have been described for radial access protocols. The objective of the study was to compare the complications experienced with PSD and TR band.

The prospective interventional study was conducted on patients who underwent coronary interventions via either DRA or FRA. The exclusion criteria were patients with an arterial diameter <2 mm, requiring dialysis, with unstable acute coronary syndrome, failed radial cannulation and sheath insertion. The PSD and TR band were used for hemostasis after DRA and FRA access respectively. The time to hemostasis and complications (after 20 days) were recorded and analyzed on IBM SPSS version 26. Mean and standard deviation were calculated for age and duration of hemostasis. Frequency and percentages were calculated for categorical variables. Independent t-test and Chi-square were applied to determine if the differences between the two groups were significant. P-value <0.05 was significant.

Out of 139 participants, TR band was used in 76 patients and PSD was used in 63 patients. The mean age of the participants was 58.70±10.00 years and majority of the patients were males (67.60%). The hemostasis time of both devices was similar (p>0.05). TR band had more complications as compared to PSD (52.63% vs. 23.81%; p=0.02), particularly radial artery occlusion (Risk: 3.17 vs. 0.32; p=0.02) and neurological problems (Risk: 5.33 vs 0.19; p<0.01).

Although, PSD seems apparently safer in patients with coronary interventions, the device should further be explored in crossover trials for the two access types to determine the overall safety profile.