Comparative Evaluation of Noninvasive Compression Adjuncts for Hemostasis in Percutaneous Arterial, Venous, and Arteriovenous Dialysis Access Procedures
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.
aDepartment of Radiology, University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103
bDepartment of Anesthesia, Stanford University Medical Center, Stanford, Calif.
ABSTRACT