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| Name | Class |
|---|---|
| I.M. Sechenov First Moscow State Medical University | OTHER |
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The purpose of this intervention study is to compare different types of radial introducers used in traditional radial access in terms of the incidence of complications.
The main questions it aims to answer are:
During the scheduled revascularization procedure, the participants will undergo radial artery catheterization using one of the types of introducers. Complications from the radiation access will be recorded by doctors within 72 hours after the intervention.
Objective: to compare different types of radial introducers used in conventional radial access by the frequency of complications.
Scientific hypotheses:
Patients were enrolled by endovascular specialists with experience of at least 250 radial-access procedures per year.
Inclusion criteria: clear pulsation of the right radial artery, indications for percutaneous coronary intervention.
Exclusion criteria: previous unsuccessful radial artery catheterization; concomitant pathology limiting patient survival; disorders of the blood coagulation system (hemophilia, thrombocytopathy, etc.); previous coronary artery bypass grafting; occlusion of the right radial artery.
The required sample size was calculated using the method of M. Bland for a high-precision study. The required significance level (α) was 0.001 and the statistical power was 95%. The expected rate of radial artery occlusion in the Rad, Rad polymer, and Rad slender groups was assumed to be 12%, 8%, and 8%, respectively. Under these conditions, the calculated sample size was 2723 patients. The planned loss during the study was 20%. Thus, the minimum sample size was 3268 patients.
The study had an experimental design and complied with the CONSORT protocol. A simple randomization method using a random-number generator was chosen. The type of randomization was permuted block randomization. The total block size was 3000, and the allocation ratio between the groups was 1:1:0.7.
Puncture of the right radial artery was performed after local anesthesia with a 2% lidocaine solution. The radial artery was punctured at the typical site using the puncture needle included in the introducer set, with only the anterior wall being punctured. The type of introducer was selected by randomization using a random-number method, and depending on this assignment the patient was allocated to one of the groups.
All patients underwent percutaneous coronary angioplasty with coronary artery stenting via the right radial artery. The radial artery catheterization technique did not differ between groups. The type of introducer was selected by randomization using a random-number method, and depending on this assignment the patient was allocated to one of the groups. In the Rad group , introducers without a hydrophilic coating were used; in the Rad polymer group , introducers with a hydrophilic coating were used; and in the Rad slender group , thin-walled introducers with a hydrophilic coating were used. The access site was examined within 3 hours after the intervention and then, in the absence of complaints, again at bandage removal. After bandage removal, patients underwent ultrasound examination to confirm radial artery patency. Complications from the radiation access will be recorded by doctors within 72 hours after the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rad classic | Active Comparator | Introducer with a standard outer diameter and no external hydrophilic coating |
|
| Rad polymer | Experimental | Introducer with a standard outer diameter and an outer hydrophilic coating |
|
| Rad slender | Experimental | Introducer with a reduced outer diameter and an outer hydrophilic coating |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| catheterization of the radial artery using an classic introducer | Procedure | The right radial artery was punctured under local anesthesia with a 2% lidocaine solution. The radial artery was punctured at a typical location using a puncture needle included in the catheterization kit, puncturing only the anterior wall. An introducer with a standard outer diameter and no external hydrophilic coating was inserted. 5,000 IU of heparin in saline solution was injected into the catheterized artery. All injected solutions, including radiocontrast agents, had a temperature of 36.5-36.7 °C. Hemostasis was achieved by applying a pressure bandage. The access site was examined 3 hours after the intervention, and then, if there were no complaints, it was examined again when the bandage was removed. After the bandage was removed, patients underwent an ultrasound examination to confirm the patency of the radial artery. Complications were recorded within 3 days after the intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Acute radial artery occlusion after catheterization | Acute radial artery occlusion was confirmed by ultrasound examination | Within 72 hours after radial artery catheterization |
| Radial artery perforation | Angiography-confirmed perforation of the radial artery | Perioperative/Periprocedural |
| Radial artery false aneurysm | A false aneurysm of the radial artery was confirmed by ultrasound examination | Within 72 hours after radial artery catheterization |
| Hematoma by classification EASY Grade II | Hematoma by classification EASY Grade II was confirmed by ultrasound examination | Within 72 hours after radial artery catheterization |
| Persistent radial artery spasm | Persistent radial artery spasm confirmed by angiography | Perioperative/Periprocedural |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| E.I. Korolev Kostroma Regional Clinical Hospital | Kostroma | Kostroma Oblast | 156013 | Russia | ||
| Central Clinical Hospital of St. Alexy Metropolitan of Moscow of the Moscow Patriarchate of the Russian Orthodox Church |
all personal data underlying the publication results
Beginning 6 months and ending 1 years after the publication of results
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 11, 2019 | May 8, 2026 |
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|
| catheterization of the radial artery using an introducer with a standard outer diameter and an outer hydrophilic coating | Procedure | Description: The right radial artery was punctured under local anesthesia with a 2% lidocaine solution. The radial artery was punctured at a typical location using a puncture needle included in the catheterization kit, puncturing only the anterior wall. An introducer with a standard outer diameter and an outer hydrophilic coating was using. 5,000 IU of heparin in saline solution was injected into the catheterized artery. All injected solutions, including radiocontrast agents, had a temperature of 36.5-36.7 °C. Hemostasis was achieved by applying a pressure bandage. The access site was examined 3 hours after the intervention, and then, if there were no complaints, it was examined again when the bandage was removed. After the bandage was removed, patients underwent an ultrasound examination to confirm the patency of the radial artery. Complications were recorded within 3 days after the intervention. |
|
| catheterization of the radial artery using an introducer with a reduced outer diameter and an outer hydrophilic coating | Procedure | Description: The right radial artery was punctured under local anesthesia with a 2% lidocaine solution. The radial artery was punctured at a typical location using a puncture needle included in the catheterization kit, puncturing only the anterior wall. An introducer with a reduced outer diameter and an outer hydrophilic coating was using. 5,000 IU of heparin in saline solution was injected into the catheterized artery. All injected solutions, including radiocontrast agents, had a temperature of 36.5-36.7 °C. Hemostasis was achieved by applying a pressure bandage. The access site was examined 3 hours after the intervention, and then, if there were no complaints, it was examined again when the bandage was removed. After the bandage was removed, patients underwent an ultrasound examination to confirm the patency of the radial artery. Complications were recorded within 3 days after the intervention. |
|
| Moscow |
| Moscow |
| 119071 |
| Russia |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 11, 2019 | May 8, 2026 | SAP_001.pdf |
| ID | Term |
|---|---|
| D001157 | Arterial Occlusive Diseases |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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