In this analysis, we found that only 7.8% of patients developed radial artery occlusion with utilization of a transradial band. Rathore S et al5 conducted a randomized correlation of TR band and radistop hemostatic pressure gadgets after transradial coronary mediation. He showed that radial artery occlusion at the time of discharge was seen in 9.2% of patients and 6.8% of patients demonstrated occlusion even at the time of follow-up. In another investigation, Pancholy SB et al assessed the impact of two distinctive hemostatic gadgets (HemoBand and Inflatable TR Band) on radial artery occlusion after transradial catheterization. In the Hemoband group, 11.2% of patients developed occlusion within 24 hours, compared with 4.4% in the Inflatable TR band group (p < 0.005). In the Hemoband group, 7.2% patients developed occlusion (at 30 days), whereas 3.2% patients developed occlusion with the Inflatable TR band. (p < 0.05). A considerable decrease in radial artery occlusion was noted with hemostasis when utilizing the TR Band in contrast with the Hemo Band11.
The incidence of RAO has been reduced in recent years because of the more utilization of radial approach. In a study by catheter laboratory, the incidence of RAO was 15% in a randomly selected group of 352 patients12.
Zankl AR et al13 detected RAO by Doppler in 10.5% patients undergoing coronary angioplasty. The number of symptomatic patients in this cohort presenting with lower arm pain was 58.5% however none of these patients had symptomatic hand ischemia. Treatment with low molecular weight heparin (LMWH) for a duration of 1 month caused arterial recanalization in 86.7% of these patients and also alleviated side effects. In another examination, 42.5% of patients with RAO reported pain in the forearm within 24hrs following the transradial coronary procedure, with another 7% of patients presenting with similar symptoms a few days later. There was no indication of acute limb ischemia in any patient. Fifty-nine percent of patients with RAO were treated with LMWH. Arterial recanalization, evaluated following 14 days, was significantly higher in the LMWH treated group compared to the group without anticoagulative treatment (55.6% versus 13.5%, p < 0.001)14.
The Prevention of Radial Artery Occlusion-Patent Hemostasis Evaluation Trial (PROPHET) investigated the effectiveness of patent hemostasis using the Hemoband (HemoBand Corporation, Portland, OR)15. Patients were randomly allocated to either a conventional pressure application for haemostasis group (occulusive haemostasis technique) or a pressure application guided by heartbeat oximetry to confirm patent haemostasis group (the ulnar artery was blocked and the HemoBand was released until a pulsatile plethysmography sign was observed). The patent haemostasis group had altogether less RAO than the control group, both at 24 hours (5% versus 12%, P < 0.05) and at 1month (1.8% versus 7.0%, P < 0.05)22. Consequently, it was suggested that the TR pneumatic pressure band is an extremely helpful and safe technique in diminishing the risk of radial artery occlusion after transradial cardiovascular catheterization.