Radial Artery Compression Comparison for Hemostasis with and without Steri-Strips Reinforcement: RACC Randomized Trial

Abstract

Objectives: This study assessed the efficacy of using steri-strips in conjunction with conventional pneumatic trans-radial (TR) bands for achieving radial artery hemostasis after diagnostic coronary angiography (CA). With varying methods aimed at reducing compression duration post-CA via trans-radial access (TRA), our aim was to evaluate time dynamics.

Methodology: We randomly assigned 209 patients in a 1:1 ratio to receive either the TR band with steri-strips (treatment) or conventional TR band alone (control) post-diagnostic CA, and followed them for one month. The primary endpoint was time to achieve adequate hemostasis, defined by the total TR band application duration. Secondary endpoints included radial artery occlusion (RAO) and major bleeding. The treatment group comprised 106 patients with steri-strips alongside the TR band, while the control group had 103 patients with the TR band alone. Median TR band application duration was 60 [IQR: 60-60] min in the treatment group and 250 [IQR: 240-360] min in the control group; p≤0.001.

Results: The incidence of site bleed requiring TR band re-application was 9.4% vs. 4.9%, p=0.364, and hematoma (type I only) was 7.5% vs. 9.7%, p=0.578 in the treatment and control groups, respectively. Radial artery palpability after 24 hours was 95.3% vs. 85.4%; p=0.016, and at one month it was 96.2% vs. 88.3%; p=0.032 in the treatment and control arms, respectively.

Conclusion: Steri-strips significantly reduce TR band compression duration and improve radial artery patency post-diagnostic angiography without causing hematoma or major bleeding complications.