Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial

Adel Aminian, Shigeru Saito, Akihiko Takahashi, Ivo Bernat, Robert Lee Jobe, Takashi Kajiya, Ian C. Gilchrist, Yves Louvard, Ferdinand Kiemeneij, Niels van Royen, Maarten van Leeuwen, Seiji Yamazaki, Takashi Matsukage, Juan F. Iglesias, Sunil V. Rao

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. Methods and Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6% vs. 1.2%, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5% vs. 2.2%, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1%, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2% vs. 4.9%, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95% CI 1.008–1.136, P = 0.03). Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.

Original languageEnglish (US)
Pages (from-to)844-851
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume92
Issue number5
DOIs
StatePublished - Nov 1 2018

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Radial Artery
Hemostasis
Coronary Angiography
Multicenter Studies
Hemorrhage
Japan
Incidence

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Aminian, Adel ; Saito, Shigeru ; Takahashi, Akihiko ; Bernat, Ivo ; Jobe, Robert Lee ; Kajiya, Takashi ; Gilchrist, Ian C. ; Louvard, Yves ; Kiemeneij, Ferdinand ; van Royen, Niels ; van Leeuwen, Maarten ; Yamazaki, Seiji ; Matsukage, Takashi ; Iglesias, Juan F. ; Rao, Sunil V. / Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients : A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial. In: Catheterization and Cardiovascular Interventions. 2018 ; Vol. 92, No. 5. pp. 844-851.
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title = "Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial",
abstract = "Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. Methods and Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6{\%} vs. 1.2{\%}, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5{\%} vs. 2.2{\%}, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1{\%}, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2{\%} vs. 4.9{\%}, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95{\%} CI 1.008–1.136, P = 0.03). Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.",
author = "Adel Aminian and Shigeru Saito and Akihiko Takahashi and Ivo Bernat and Jobe, {Robert Lee} and Takashi Kajiya and Gilchrist, {Ian C.} and Yves Louvard and Ferdinand Kiemeneij and {van Royen}, Niels and {van Leeuwen}, Maarten and Seiji Yamazaki and Takashi Matsukage and Iglesias, {Juan F.} and Rao, {Sunil V.}",
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Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients : A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial. / Aminian, Adel; Saito, Shigeru; Takahashi, Akihiko; Bernat, Ivo; Jobe, Robert Lee; Kajiya, Takashi; Gilchrist, Ian C.; Louvard, Yves; Kiemeneij, Ferdinand; van Royen, Niels; van Leeuwen, Maarten; Yamazaki, Seiji; Matsukage, Takashi; Iglesias, Juan F.; Rao, Sunil V.

In: Catheterization and Cardiovascular Interventions, Vol. 92, No. 5, 01.11.2018, p. 844-851.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients

T2 - A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial

AU - Aminian, Adel

AU - Saito, Shigeru

AU - Takahashi, Akihiko

AU - Bernat, Ivo

AU - Jobe, Robert Lee

AU - Kajiya, Takashi

AU - Gilchrist, Ian C.

AU - Louvard, Yves

AU - Kiemeneij, Ferdinand

AU - van Royen, Niels

AU - van Leeuwen, Maarten

AU - Yamazaki, Seiji

AU - Matsukage, Takashi

AU - Iglesias, Juan F.

AU - Rao, Sunil V.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. Methods and Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6% vs. 1.2%, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5% vs. 2.2%, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1%, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2% vs. 4.9%, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95% CI 1.008–1.136, P = 0.03). Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.

AB - Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. Methods and Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6% vs. 1.2%, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5% vs. 2.2%, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1%, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2% vs. 4.9%, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95% CI 1.008–1.136, P = 0.03). Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.

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SN - 1522-1946

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