Pressure-guided pneumatic compression was associated with lower observed RAO rates and more favorable hemostatic and local outcomes than conventional screw-type compression after transradial coronary procedures, in a single-center retrospective cohort.
Key Findings
Results
The pressure-guided pneumatic compression group had a lower observed rate of radial artery occlusion (RAO) at 24 hours than the conventional screw-type compression group.
RAO at 24 h was 2.8% (7/254) in the observation group vs. 7.7% (20/260) in the control group, p = 0.012.
The study was a single-center retrospective historical cohort of 514 consecutive patients treated between February and December 2025.
The control group received conventional screw-type compression with clinically guided staged adjustment; the observation group received pneumatic compression with quantitative pressure measurement and individualized staged adjustment.
RAO at 24 h was the primary outcome.
Results
After adjustment with Firth penalized logistic regression, the pneumatic protocol remained associated with lower odds of RAO at 24 hours.
Adjusted OR = 0.358, 95% CI: 0.143-0.809; p = 0.013.
Firth penalized regression was used, which is suited to analyses with few events.
Results
RAO at 7 days was also lower in the observation group.
RAO at 7 days was 2.0% (5/254) in the observation group vs. 5.4% (14/260) in the control group, p = 0.040.
This was a secondary outcome.
Results
Patients in the observation group reported lower pain scores at 6 and 24 hours.
Pain scores were lower at both 6 h and 24 h (both p < 0.001).
Pain was a secondary outcome.
Results
Digital SpO2 values were higher in the observation group at 2, 4, and 24 hours.
Differences were significant at 2, 4, and 24 h (all p < 0.001).
SpO2 was a secondary outcome.
Results
Primary hemostatic success was higher in the observation group.
Primary hemostatic success was 97.2% vs. 93.5%, p = 0.042.
Results
The observation group had fewer patients with puncture-site oozing and fewer with at least one local complication.
Puncture-site oozing occurred in 2.8% vs. 6.9%, p = 0.028.
At least one local complication occurred in 11.4% vs. 28.1%, p < 0.001.
Conclusions
The authors conclude that pressure-guided pneumatic compression was associated with more favorable RAO, hemostatic and local outcomes, with design limitations noted.
The study was a retrospective cohort and did not involve a prospective intervention, so clinical trial registration was not required.
Group allocation was historical rather than randomized, and findings are expressed as associations.
What This Means
After a heart procedure done through the wrist artery, a compression device is used to stop bleeding at the puncture site. If too much or too little pressure is used, the artery can become blocked (radial artery occlusion) or the site can bleed. This study compared two ways of applying that pressure in 514 patients at one hospital: a conventional screw-type band adjusted by clinical judgment, and an air-inflated (pneumatic) band where pressure was actually measured and adjusted step by step for each patient.
Patients in the measured-pressure group had fewer blocked arteries at 24 hours (2.8% vs. 7.7%) and at 7 days (2.0% vs. 5.4%). Even after statistical adjustment, the odds of blockage were lower in this group. These patients also reported less pain, had higher finger oxygen readings, were more likely to have bleeding stopped on the first attempt, and had fewer local problems such as oozing at the puncture site.
This research suggests that measuring and individualizing compression pressure may help reduce wrist-artery blockage and local complications. However, the study was retrospective, took place at a single center, and compared patients treated in different periods rather than randomly assigning them, so other differences could account for some of the results. Prospective randomized trials would be needed to confirm the benefit.