Radial Hemostasis Is Facilitated With a Potassium Ferrate Hemostatic Patch: The STAT2 Trial.

Jordan G Safirstein, David M Tehrani, Jeffrey M Schussler, Nicole Reid, Kush Mukerjee, Larissa Weber, Henry Liu, Shea Skenderian, Michael Simeon, Tyler Yang, Arnold H Seto

Journal: JACC. Cardiovascular interventions 2022;15(8):810-819

PMID: 35450681

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Abstract

OBJECTIVES

The aim of this trial was to test whether the potassium ferrate hemostatic patch (PFHP) as an adjunct to the TR Band (TRB) facilitated an early deflation protocol.

BACKGROUND

Shorter TRB compression times may reduce the rate of radial artery occlusion (RAO) and reduce observation time after transradial access.

METHODS

A total of 443 patients were randomized to the TRB or PFHP + TRB, with complete TRB deflation attempted 60 minutes postprocedure. The primary outcome was the time to successful full deflation of the TRB without bleeding, with secondary outcomes of time to discharge and complications including hematoma, RAO, or bleeding requiring intervention beyond TRB reinflation.

RESULTS

Time to complete TRB deflation was 66 ± 14 minutes with the PFHP vs 113 ± 56 minutes for the TRB alone (P < 0.001). Minor rebleeding requiring TRB reinflation was much more frequent without the PFHP (0% vs 67.7%; P < 0.001) with 2.3 ± 1.3 additional reinflation and deflation attempts needed for hemostasis. Hematomas developed in 4.0% of the PFHP group and 6.8% of the TRB group (P = 0.20). RAO was rare (<1%), although 41% of patients received <5,000 U heparin. Among percutaneous coronary intervention patients, time to TRB deflation (68 ± 15 minutes vs 138 ± 62 minutes; P < 0.001) and composite complications (10.0% vs 24.2%; P = 0.04) were reduced with the PFHP.

CONCLUSIONS

Compared with the TRB alone, the PFHP facilitated early 60-minute TRB deflation following transradial catheterization, with a numeric reduction in vascular complications. RAO occurs rarely with early deflation regardless of heparin dose. (Comparing TR Band to StatSeal in Conjunction With TR Band II [StatSeal II]; NCT04046952).

Published by Elsevier Inc.

Address: Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey, USA.; University of California-Los Angeles, Medical Center, Los Angeles, California, USA.; Division of Cardiology, Baylor University Medical Center, Dallas, Texas, USA.; California University of Science and Medicine, Colton, California, USA.; University of California-Berkeley, Berkeley, California, USA.; Saint Louis University, St. Louis, Missouri, USA.; University of California, Irvine, School of Medicine, Orange, California, USA.; University of California, Irvine, School of Medicine, Orange, California, USA; Division of Cardiology, Department of Medicine, Tibor Rubin VA Medical Center, Long Beach, California, USA. Electronic address: [email protected].

DOI: 10.1016/j.jcin.2021.12.030