Protamine sulfate shortens postoperative compression time after DTRA coronary angiography

Protamine sulfate shortens postoperative compression time after DTRA coronary angiography

Announcing a new article publication forCardiovascular innovations and applicationsMagazine. With distal transradial access (DTRA), the postoperative compression time remains significantly longer than the recommended range in practice. This study investigates whether intravenous protamine sulfate could shorten postoperative compression time and increase safety after coronary angiography via DTRA.

In this retrospective study, patients undergoing coronary angiography were enrolled and divided into two groups. The study group received a slow intravenous injection of 15 to 20 mg of protamine sulfate before withdrawal. The primary endpoint was time compression time after coronary angiography.
A total of 97 patients in the protamine group and 293 in the control group were included. Intraoperative heparin use, contrast dose, angiography duration, and radiation dose did not differ significantly between groups.

The mean compression time in the control group was 2.9 ± 0.5 hours, while in the protamine group it was 1.6 ± 0.9 hours (p < 0.001). No significant difference was observed in postoperative minor or major bleeding or hematoma between groups. Ultrasound 24 hours after angiography showed an incidence of radial artery thrombosis of 1.1% in the control group and 4.3% in the protamine treatment group, with no statistically significant difference between the groups (p = 0.209) and no radial artery occlusion in either group.

Logistic regression suggested that radial artery thrombosis was associated with intraoperative heparin dose and a history of chronic kidney disease.

Intravenous use of protamine after coronary angiography via DTRA can significantly shorten the time of postoperative compression hemostasis and achieve good performance in terms of safety.

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