Comparative Evaluation of Noninvasive Compression Adjuncts for Hemostasis in Percutaneous Arterial, Venous, and Arteriovenous Dialysis Access Procedures

Wang, David S.; Chu, Larry F.; Olson, Scott E.; Miller, Frank J.; Valji, Karim; Wong, Wade H.; Rose, Steven C.; Austin, Matthew; Kuo, Michael D.

doi:10.1016/j.jvir.2007.08.028

« Previous Next »Journal of Vascular and Interventional Radiology
Volume 19, Issue 1 , Pages 72-79, January 2008

Comparative Evaluation of Noninvasive Compression Adjuncts for Hemostasis in Percutaneous Arterial, Venous, and Arteriovenous Dialysis Access Procedures

David S. Wang, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Larry F. Chu, MD
- Department of Anesthesia, Stanford University Medical Center, Stanford, Calif.
Scott E. Olson, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Frank J. Miller, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Karim Valji, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Wade H. Wong, DO
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Steven C. Rose, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Matthew Austin, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
Michael D. Kuo, MD
- Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
- M.D.K. has consulted for Biolife.
- Address correspondence to M.D.K.

Received 14 June 2007; received in revised form 11 August 2007; accepted 14 August 2007.

Purpose

To assess the relative efficacy of three compression adjuncts—D-Stat Dry (D-Stat), QR Powder (QR), and XS Powder (XS)—for reducing time to hemostasis in patients who underwent diagnostic and interventional percutaneous procedures.

Materials and Methods

D-Stat, QR, or XS was applied in 176 percutaneous diagnostic arterial, therapeutic arterial, venous, and arteriovenous dialysis access (AVDA) procedures in 138 patients. The mean time to hemostasis and application-related complications were retrospectively assessed.

Results

Mean time to hemostasis was significantly reduced in all applications of QR (3.1 minutes ± 1.1) and XS (3.7 minutes ± 1.1) relative to D-Stat (6.2 minutes ± 1.1, P < .001 vs both). For therapeutic arterial procedures, mean time to hemostasis for QR and XS was 3.6 minutes ± 1.1 and 4.8 minutes ± 1.1, respectively, and this was significantly less than that of D-Stat (10.0 minutes ± 1.2; P < .001 vs QR, P < .01 vs XS). Mean times to hemostasis for QR and XS were also shorter than that with D-Stat in diagnostic arterial and AVDA procedures (P < .05). For venous procedures, mean time to hemostasis for QR (1.9 minutes ± 1.2) was significantly shorter than that with both D-Stat (4.0 minutes ± 1.2, P < .05) and XS (3.7 minutes ± 1.2, P < .05). Minor immediate complications (hematoma <5 cm) occurred in 2.8% of applications. No access site infections were observed.

Conclusions

All three agents effectively reduced time to hemostasis with minimal associated complications. QR was found to be more effective than D-Stat in all four procedure types.