Efficacy and Safety of Hemostatic Methods in Distal Radial Artery Approach for Cardiac Catheterization

Comparison of PreludeSYNC distal and Modified Terumo Radial Band in patients with distal radial approach.

INTRODUCTION AND BACKGROUND

Distal radial access at the level of the anatomical snuffbox and dorsal region of the hand has currently positioned itself as a viable and safe approach for procedures in interventional cardiology, whether diagnostic, simple, or complex angioplasties. We know that this approach method mainly reduces the occlusion rate of the proximal radial artery, among other advantages; however, we still do not have scientific evidence on the various hemostasis methods for this approach. Practice varies between centers and countries and hemostasis methods vary from an elastic compression bandage to the use of devices manufactured specifically for this approach such as the PreludeSYNC DISTAL or modification of devices manufactured for proximal radial hemostasis such as the TR band. In this clinical trial, we intend to analyze the efficacy and safety of two hemostasis methods in patients who require an interventional procedure (PredludeSYNC DISTAL vs modified TR band), to date, there is no clinical trial that compares these methods face to-face in relation to their efficacy and safety. Retrospective studies indicate that both methods are effective in reducing radial artery occlusion and are safe in reducing the bleeding/hematoma rate.

THE PURPOSE OF THE STUDY To compare the efficacy (distal radial artery occlusion) and safety (hematoma/bleeding) of two devices of distal radial hemostasis (PreludeSYNC distal and TR band) in patients undergoing percutaneous coronary intervention.

STUDY DESIGN Experimental, randomized, prospective, longitudinal, prolective, and comparative.

SUBJECTS OF STUDY Patients from the Ignacio Chávez National Institute of Cardiology who will undergo distal radial percutaneous coronary intervention/angiography.

METHODOLOGY After signing the informed consent, patients will be randomized by balanced block methods to: 1) Hemostasis using the PreludeSYNC distal device, or 2) Hemostasis using the Modified Radial Band device.

PRIMARY OUTCOME To compare the efficacy (distal radial artery occlusion) and safety (hematoma/bleeding) of PreludeSYNC distal versus Modified Terumo Radial Band in distal radial approach.

Eligibility Criteria:
Inclusion Criteria:

* Coronary artery disease including chronic coronary syndrome or acute coronary syndrome.
* Cardiovascular disease that requires coronary angiography in its approach.

Exclusion Criteria:

* Cardiogenic shock.
* Lesions in venous or arterial hemoducts.
* Impossibility to provide informed consent.
* Chronic kidney disease on hemodialysis through arteriovenous fistula at the same site where the approach is planned.
* Severe chronic renal failure (GFR less than 30 ml/min/m2)
* Patients diagnosed with cancer.
* Patient with rheumatological and hematological pro-thrombotic disorders.
* Non-hydrophilic radial introducer.
* Failed cannulation of the radial artery with an introducer.
* Successful trans-radial access that is crossed over to the femoral approach.
* Patients with an interventional procedure using a radial approach in the previous 30 days.