Comparison of The Effectiveness of Different Prototypes of Wrist Support in Prevention of Radial Hematoma and Bleeding After Transradial Coronary Angiography among Patients Undergoing Percutaneous Coronary Interventions: A Retrospective Study

Main Article Content

Nuttakan Sujaiya
Wipawan Promlungka
Niramol Balchon
Jutarut Saikam
Pongtorn Kietdumrongwong
Thitima Wiriya
Somkiat Tonphu
Warut Chaiwong

Abstract

OBJECTIVES: To compare the proportion of hematoma and bleeding occurrences between P1, P2, and P3 holding wrist supports as well as to evaluate the user satisfaction of P3 wearers among patients who underwent transradial access site procedures.


MATERIALS AND METHODS: This study is retrospective drawing on analytical data from Bangkok Hospital Chiang Mai medical records whose patients underwent percutaneous coronary interventions (PCI); 136 cases were gathered between June 1, 2019 – December 31, 2021. The division of the samples into three groups was based on the duration of use for each device namely prototypes as follows: Wrist Supported Prototype 1 (P1) group, Wrist Supported Prototype 2 (P2) group, and Wrist Supported Prototype 3 (P3) group. The baseline characteristics were presented as frequency (%) and Chi-square test or Fisher’s exact test was used to evaluate the difference in variables between the 3 groups. Chi-square test was used to compare the proportion of hematoma and bleeding. A p < 0.05 was considered statistically significant.


RESULTS: Patients undergoing PCI, 133 cases, who satisfied the criteria for eligibility were divided into 3 groups; 8 cases in P1 group, 80 cases in P2 group and 45 cases in P3 group. The findings on hematoma revealed 1 case (1.3%) among the P2 group and no hematoma among the P1 and P3 groups, respectively, 6 hours after the sheath was taken off. The number of cases of bleeding were discovered as follows: 2 cases (25.0%), 33 cases (41.2%) and 13 cases (28.9%) among P1, P2 and P3 groups, respectively, 6 hours after sheath was taken off. There were no significant differences on the proportion of bleeding among three groups (p = 0.307). The demographic data differences between the three groups were not statistically significant, except for dyslipidemia which was significantly different (p = 0.023). In this study, wrist support Prototype 3 users was 45 cases, and the overall patient satisfaction average score was 4.96 ± 0.23. The wrist support Prototype 3’s ease of use and patient satisfaction average scores were 5.00 at the highest possible level.


CONCLUSION: Wrist support is used for support and limited moving of the wrist after a patient has undergone PCI. P3 group had the highest satisfaction rating for wrist support among users. This study revealed that the differences in bleeding post-PCI between P1, P2 and P3 groups were not statistically significant (p = 0.307). The hematoma results were not deemed sufficient for statistical analysis.

Article Details

How to Cite
1.
Sujaiya N, Promlungka W, Balchon N, Saikam J, Kietdumrongwong P, Wiriya T, Tonphu S, Chaiwong W. Comparison of The Effectiveness of Different Prototypes of Wrist Support in Prevention of Radial Hematoma and Bleeding After Transradial Coronary Angiography among Patients Undergoing Percutaneous Coronary Interventions: A Retrospective Study. BKK Med J [Internet]. 2024 Sep. 30 [cited 2024 Nov. 11];20(2):109. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/268868
Section
Original Article

References

Garg N, Umamaheswar KL, Kapoor A, et al. Incidence and predictors of forearm hematoma during the transradial approach for percutaneous coronary interventions. Indian Heart J. 2019;71(2):136-42. doi: 10.1016/j.ihj.2019.04.014.

Ferrante G, Rao SV, Jüni P, et al. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease a meta-analysis of randomized trials. JACC Cardiovasc Interv 2016;9(14):1419- 34. doi: 10.1016/j.jcin.2016.04.014. 3. Nantasukhon A, Ausawakijpanich S, Siripittayakunkit A. A study of the patients’ vascular complications and pain after cardiac catheterization between transfemoral artery and transradial artery approach at post catheterization care unit, Ramathibodi hospital. [Internet]. 2019. (Accessed February 28, 2021, at https://repository.li.mahidol.ac.th/handle/123456789/55137)

Nakarin S, Mann C, Suphot S, et al. Predictors of major adverse cardiovascular events in coronary artery patients undergoing percutaneous coronary intervention (PCI) in Thailand: Thai PCI Registry. 2021. [Internet]. 2020. (Accessed 2022 May 12, 2022, at https://kb.hsri.or.th/dspace/handle/11228/5219)

Riangwiwat T, Blankenship JC. Vascular complications of transradial access for cardiac catheterization. US Cardio Rev. 2021;15:e04. doi: 10.15420/usc.2020.23

Dwivedi SK, Nayak G, Sharma AK, et al. Forearm hematoma as a complication of transradial coronary intervention: an Indian single-center experience. Am J Cardiovasc Dis. 2021;11(4):462-70.

Mrdovic I, Savic L, Krljanac G, et al. Simple risk algorithm to predict serious bleeding in patients with ST-segment elevation myocardial infarction undergoing primary Percutaneous Coronary Intervention – RISK-PCI bleeding score. Circ J. 2013;77(7):1719-27. doi: 10.1253/circj.cj-12- 1177.

Supa J, Rachanee N. Factors related to the occurrence of vascular complications among patients receiving percutaneous coronary interventions via the femoral artery. APHEIT J. 2017; (6)2:14-24.

ECRI Institute & ISMP under contract to the Patient Safety Authority. Strategies to minimize vascular complications following a cardiac catheterization. PA-PSRS Patient Saf Advis 2007; 4(2):58-63.

Jati, Yuliastuti C, Rinarto N. The nurses’ compliance in femoral sheath removal procedure in relation to the incidence of hematoma in patients after PTCA. In proceeding of the 9th international nursing conference (INC 2018), 2018:621-25. doi: 10.5220/0008329806210625

Mookda N, Chaniporn S. Arm and wrist support KhunprakongKhansabai. 4th Service Plan Sharing 2017: Road to service plan 4.0 2017;138-9.

Pholtana S. Development of naval wrist support for support patients undergoing transradial cardiac catheterization: a case study of Somdech Phra Pinklao Hospital. Wittayasara: Integration Apply Engineering and Industrial Technology 2023;16(1):54-69

Non communicable disease epimiological surveillance development system group, the epidemiology division, the Department of Disease Control, and the Ministry of Public Health. Coronary Artery Disease (CAD) situation 2018 [Internet]. Bangkok; 2018. (Accessed November 25, 2023, at http://ddc.moph.go.th/uploads/files/1081120191227091554. pdf).

Malik J, Javed N, Naeem H. A comparative study of Terumo radial Band® and PreludeSYNC hemostasis compression device after transradial coronary catheterization. Anatol J Cardiol. 2021;25(6):402-6. doi: 10.14744/AnatolJCardiol.2020.34694.

Riyami HA, Riyami AA, Nadar SK. Comparison between two protocols for deflation of the TR band following coronary procedures via the radial route. J Saudi Heart Assoc. 2020;32(1):52-56. doi: 10.37616/2212-5043.1009.

Smeds MR, Soult MC. Access-related complications of percutaneous access for diagnostic or interventional procedures. UpToDate [Internet]. 2022. (Accessed November 25, 2023, at https://medilib.ir/uptodate/show/15202).