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Trial registered on ANZCTR
Registration number
ACTRN12624000830594
Ethics application status
Approved
Date submitted
20/06/2024
Date registered
5/07/2024
Date last updated
5/07/2024
Date data sharing statement initially provided
5/07/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of an accelerated deflation protocol with standard practice for radial compression device following cardiac catheterisation
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Scientific title
Comparison of an accelerated deflation protocol with standard practice for radial compression device following cardiac catheterisation in patients admitted for angiography and/or percutaneous coronary intervention with radial access
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Secondary ID [1]
312375
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Coronary Heart Disease
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Acute Coronary Syndrome
334165
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Condition category
Condition code
Cardiovascular
330835
330835
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Cardiac catheterisation is an invasive cardiac procedure performed for diagnostic (angiography) and/or therapeutic (percutaneous coronary intervention [PCI]) purposes. Transradial approach to catheterisation is common, and bleeding from the radial artery puncture site can occur when the catheter is removed. At Fiona Stanley Hospital (FSH), pressure is applied to the site post procedure for 1-2 hours to achieve haemostasis using an inflated TR Band® that is then incrementally deflated by nursing staff before removal. .
The TR Band® is applied to the patient’s wrist in the cardiac catheter laboratory during removal of the catheter sheath by staff trained in this procedure. As per current policy at FSH, TR Band® deflation commences at 60 minutes after angiogram and 120 minutes after angioplasty. TR Band® deflation involves deflating the balloon by removing 3mls of air every 10 minutes until all air is removed and the TR Band® is completely deflated. Deflation is performed by nurses deemed competent in this practice and who monitor bleeding and heamatoma formation during the deflation process. Adherence to the intervention will be monitored by site investigators by direct observation.
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Intervention code [1]
328872
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Treatment: Devices
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Comparator / control treatment
The accelerated deflation protocols for this trial were developed following a literature review of similar studies and in discussion with senior nursing and medical cardiology staff at the site who are experts in cardiac catheterisation procedures. The accelerated protocols were agreed upon by consensus.
ANGIOGRAM
Control A - Standard deflation protocol - angiogram
* After 60mins, begin deflation 3ml each 10min until fully deflated
Intervention A -Accelerated deflation protocol - angiogram
* After 60min, deflate 50% of air in TR band
* After 15mins, deflated remaining 50% of air
PERCUTANEOUS CORONARY INTERVENTION
Control B - Standard deflation protocol - Percutaneous Coronary Intervention (PCI)
* After 120mins, begin deflation 3ml each 10min until fully deflated
Intervention B -Accelerated deflation protocol - Percutaneous Coronary intervention (PCI)
* After 90min, deflate 50% of air in TR band
* After 15mins, deflated remaining 50% of air
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Control group
Active
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Outcomes
Primary outcome [1]
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• The incidence of bleeding complications determined by: (a) bleeding at the site requiring intervention and/or (b) presence of haematoma
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Assessment method [1]
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Early Discharge after Transradial Stenting of Coronary Arteries Study (EASY) Haematoma grading tool
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Timepoint [1]
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Commencement of deflation through to 4 hours post removal of TR Band
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Secondary outcome [1]
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Total inflation time (minutes) determined by the time from TR Band® inflation to removal
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Assessment method [1]
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Time in minutes as calculated by the time of inflation until time of complete deflation documented in the patient's medical care record
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Timepoint [1]
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End of deflation
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Secondary outcome [2]
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Number of TR Band deflation steps
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Assessment method [2]
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Review of medical care record
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Timepoint [2]
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Control group A - at 60mins post inflation (3mls deflation), then each 10mins (3ml deflation) until fully deflated (end of deflation)
Control group B -at 120mins post inflation (3mls deflation), then each 10mins (3ml deflation) until fully deflated (end of deflation)
Intervention A - at 60mins post inflation (50% deflation), then at 15min time (remaining 50%, end of deflation)
Intervention B - at 90mins post inflation (50% deflation), then at 15min time (remaining 50%, end of deflation)
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Secondary outcome [3]
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Patient comfort
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Assessment method [3]
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Numerical Pain Rating scale
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Timepoint [3]
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End of deflation
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Eligibility
Key inclusion criteria
Patients admitted for angiography and/or percutaneous coronary intervention with radial access
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Inability to obtain informed consent
* Procedure requiring femoral access
* Peri-procedural complications including bleeding, haematoma, difficult radial artery access
* Discretion of the treating interventional cardiologist if it's not in the patient's best interest
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created
by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
19/08/2024
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Actual
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Date of last participant enrolment
Anticipated
4/10/2024
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Actual
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Date of last data collection
Anticipated
29/12/2024
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
42752
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6150 - Murdoch
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Frances Jones Research and Education Fund
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Address [1]
316782
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Fiona Stanley Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
319001
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None
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Name [1]
319001
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Address [1]
319001
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Country [1]
319001
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Metropolitan Health Service Human Research Ethics Committee
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Ethics committee address [1]
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https://smhs.health.wa.gov.au/Our-research/For-researchers
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/05/2024
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Approval date [1]
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24/05/2024
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Ethics approval number [1]
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RGS0000006845
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Summary
Brief summary
Cardiac catheterisation is an invasive cardiac procedure performed for diagnostic (angiography) and/or therapeutic (percutaneous coronary intervention [PCI]) purposes. Transradial approach to catheterisation is common, Current protocols for TR Band® deflation have been noted by staff as challenging to meet, with a recent audit identifying inconsistencies in practice and delayed deflations. Prolonged inflation times can increase the risk of radial artery occlusion (RAO). Evidence suggests that accelerated deflation protocols are safe and feasible and may reduce patient discomfort and length of stay. Various protocols have been developed and tested however, few assessed bleeding outcomes, efficiency of deflation and patient comfort. This study aims to assess the feasibility of accelerated protocols for TR Band® deflation. Outcome measures will be bleeding complications, deflation time/steps and patient comfort.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mrs Narelle Read
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Address
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Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch WA 6150
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Country
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Australia
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Phone
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+618 61521713
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Narelle Read
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Address
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Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch WA 6150
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Country
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Australia
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Phone
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+618 61521713
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Carrie Janerka
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Address
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Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch WA 6150
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Country
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Australia
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Phone
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+618 6511205
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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