Introduction/Purpose Transradial access for neurovascular procedures has gained prominence recently given improved safety benefits, reduced healthcare costs, and patient preference. The addition of a potassium ferrate patch (StatSeal) prior to achieving access site hemostasis has been shown in other fields to reduce time to transradial band removal, and thus, recovery time. We sought to review our experience with this device in our neurovascular patient population.
Materials and Methods A retrospective single-center series review was conducted with 43 patients and 50 consecutive procedures. A transradial sheath (Terumo Glidesheath slender) was used in all procedures. Heparin 5000 units was administered as an IV bolus in all patients. Re-administration of IV heparin during procedure to maintain ACT >250 was dependent on the case. Patient hemostasis was achieved with transradial band (TR band (Terumo) for proximal radial; (Merit) PreludeSYNC Distal for ‘distal’ radial access) following application of StatSeal. The band was inflated to 8cc air. Half of the air was removed after 15 minutes, and the remaining air was removed after 30 minutes. The access site was monitored for another 30 minutes with a completely deflated band in place. StatSeal was removed 24 hours later.
Results In the 50 total procedures, distal (35 procedures) and proximal radial access sites(15 procedures) were utilized. 48 procedures utilized the right radial access, and 2 procedures utilized the left radial access. 33 procedures were cerebral angiograms, and 17 procedures were neurovascular interventions. Different sheaths were utilized (5F sheath (33 procedures), 6F sheath (16 procedures) and a 7F sheath (1 procedure)). No hematomas grade 2 or above reported. No access site complications were reported. 21 patients had concomitant anticoagulant treatment (DAPT (11 patients), Aspirin (5 patients), and NOAC (5 patients)).
Conclusion An accelerated deflated algorithm, with complete band deflation within 30 minutes, in conjunction with StatSeal is safe and effective to achieve rapid, patent hemostasis in neurovascular patients undergoing traditional and ‘distal’ transradial access. Of the 50 procedures, 35 procedures utilized the distal radial access, and 15 procedures utilized the proximal radial access. 48 procedures utilized the right radial access, and 2 procedures utilized the left radial access. 33 procedures were cerebral angiograms, and 17 procedures were neurovascular interventions. 5F sheath was used for 33 procedures, 6F sheath was used for 16 procedures, and a 7F sheath was used for 1 procedure. There were no hematomas grade 2 or above. No access site complications were reported. 21 patients had concomitant anticoagulant treatment (11 patients on DAPT, 5 patients on aspirin, and 5 patients on NOAC).
Disclosures K. Mantripragada: None. S. Mansour: None. N. Echeverry: None. E. Hospedales: None. S. Shapiro: None. B. Snelling: None.
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