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.

Centre Hospitalier Universitaire de Charleroi Charleroi Belgium

Geneva University Hospital Geneva Switzerland

Institut Hospitalier Jacques Cartier Massy France

Isala Heart Center Zwolle The Netherlands

MC Zuiderzee Lelystad The Netherlands

Pennsylvania State University Heart and Vascular Institute Hershey Pennsylvania

Sakurakai Takahashi Hospital Kobe Japan

Sapporo Higashi Tokushukai Hospital Hokkaido Japan

Shonan Kamakura General Hospital Kanagawa Japan

Tenyoukai Central Hospital Kagoshima Japan

Tergooi Hospital Blaricum The Netherlands

The Duke Clinical Research Institute Durham North Carolina

Tokai University School of Medicine Isehara Japan

UNC Rex Healthcare Raleigh North Carolina

University Hospital and Faculty of Medicine Pilsen Pilsen Czech Republic

VU University Medical Center Amsterdam The Netherlands

Catheter Cardiovasc Interv. 2018 Nov 1;92(5):852-853. doi: 10.1002/ccd.27942. PubMed

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A Randomized Trial Comparing Short versus Prolonged Hemostasis with Rescue Recanalization by Ipsilateral Ulnar Artery Compression: Impact on Radial Artery Occlusion-The RESCUE-RAO Trial