Hemostasis following transradial access (TRA) is usually achieved by mechanical compression. Limited studies have been conducted on using QUIKCLOT RADIAL for TRA hemostasis. This study aims to evaluate the efficacy of QUIKCLOT RADIAL in achieving significant radial hemostasis within 60 minutes post-procedure, with no incidence of radial artery occlusion (RAO).

QUIKCLOT RADIAL, a kaolin-based hemostatic agent, was used in a prospective registry of patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) via transradial approach in our cardiac lab. Post-procedure, trained staff applied QUIKCLOT RADIAL. The application involved affixing the provided band over the wrist with the sheath in place, inserting the QUIKCLOT RADIAL pad from the proximal end of the sheath, removing the sheath, and applying manual compression for 5-10 minutes. An initial reverse Barbeau Test was performed and documented. Neurovascular assessments were conducted at 15-minute, 30-minute, and hourly intervals for 3 to 4 hours. Successful hemostasis was defined as being achieved within 60 minutes. Patients were monitored for post-procedural complications, with a second reverse Barbeau Test performed on post-procedure day 1. Trans-radial associated complications, including hematoma and radial artery occlusion, were assessed.

Eleven patients underwent CA or PCI via transradial approach from mid-June to July 2024. Of these, 27.27% (n=3) underwent CA and 72.73% (n=8) underwent PCI. The PCI group received an average Heparin dose of 7625 units and a median dose of 8500 units, with a median ACT of 494.5 seconds and an average ACT of 303 seconds. 38% (n=3) of patients received intracoronary and intravenous Integrilin (IIbIIIa inhibitors) for an average of 16 hours at 2mcg/kg/min, while 12.5% (n=1) received only intracoronary Integrilin. 73% (n=8) had a single puncture, and 27% (n=3) had multiple punctures. One patient (9%) had a previous arterial puncture within 2 weeks. Hemostasis was achieved in 100% of patients within 60 minutes, with no bleeding observed at the radial site. 54.55% (n=6) had QUIKCLOT RADIAL removed within 55-60 minutes, while 45.45% (n=5) had it removed at 65-93 minutes due to logistical reasons. No significant radial hematoma was observed; 55% (n=6) experienced mild Grade I forearm hematoma, managed without surgical intervention. No RAO was observed, with all patients showing a positive reverse Type A Barbeau Test on post-procedure day 1.

QUIKCLOT RADIAL successfully achieved radial hemostasis in all patients within 60 minutes without major complications. Minimal hematoma was observed, and no patients developed radial artery occlusion.