A Systematic Review of the Safety of Balloon Compression Hemostat with Different Initial Decompression Time after Radial Artery Intervention
Objective:To evaluate the safety of different initial deflation and decompression time of balloon compression hemostat on postoperative safety of patients after radial artery intervention,and to explore the best initial deflation time.Methods:Randomized controlled trials(RCTs)including the effects of different initial decompression time of balloon compression hemostat on postoperative adverse reactions and complications of PubMed,Web of Science,EMbase,China Journal Full-Text Database(CNKI),VIP and WanFang Databases from January 1,2005 to December 15,2021 were searched.Two researchers independently screened and evaluated the qualified literature,and the final literature was determined to be included after the evaluation of the third researcher.RevMan 5.4 software was used for Meta-analysis and R 4.2 software was used for sensitivity analysis.Results:A total of 27 literatures were included,including 5 843 patients.Meta-analysis results showed that compared with postoperative>2 h initial deflation decompression,postoperative 2 h initial deflation decompression showed with lower arterial occlusion(RAO)(RR=4.90,95%CI 1.69-14.24,P =0.003),lower incidence of limb numbness(RR=3.16,95%CI 2.14-4.65,P<0.000 01),and lower incidence of limb cyanosis(RR=4.35,95%CI 2.36-8.02,P<0.01).Compared with initial deflation and decompression after 2 hours postoperatively,initial deflation and decompression within 2 hours postoperatively showed with lower incidence of acute RAO(RR=0.44,95%CI 0.20-0.97,P =0.04),lower incidence of limb swelling(RR=0.41,95%CI 0.27-0.63,P<0.000 1),lower incidence of limb numbness(RR=0.49,the 95%CI 0.34-0.70,P<0.000 1),lower incidence of limb cyanosis(RR=0.37,95%CI 0.18-0.75,P =0.006),and lower incidence of pain at the patient's puncture site(RR=0.50,95%CI 0.34-0.73,P =0.000 3).The sensitivity analysis was performed using the literature-by-exclusion method,and the results did not change significantly before and after exclusion,suggesting that the results of Meta-analysis were stable and credible.Conclusion:The current evidence showed that based on the results of Meta-analysis,the time of initial deflation and decompression of the balloon compression hemostat<2 h after radial artery intervention was more effective than 2 h or>2 h in preventing the occurrence of postoperative acute RAO,swelling of the limbs,limb cyanosis,and pain at the puncture site.
万方数据
维普
