ORIGINAL RESEARCH article
Front. Med.
Sec. Hematology
This article is part of the Research TopicEndothelium, Innate Immunity and Coagulation in Hematological DisordersView all 24 articles
Predictors and Clinical Outcomes of Incomplete Hemostasis Following Transradial Coronary Intervention: The Role of Activated Clotting Time and Procedural Factors
Provisionally accepted
Jong-Hwa Ahn*
Yujin ShinJae Myoung LeeYong-Lee Kim
Ga-In YuJae Seok BaeYun-Ho ChoJeong Yoon JangYongwhi ParkChoong Hwan Kwak- Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Abstract Background: Major vascular complications are less frequent with trans-radial artery (TRA) access compared to transfemoral artery access. However, a substantial proportion of patients experience incomplete hemostasis following TRA intervention. This study aimed to identify factors associated with incomplete hemostasis and evaluate the predictive value of pre-and post-procedural activated clotting time (ACT). Methods: A total of 1,241 patients who underwent TRA intervention were included in a prospectively maintained single-center registry. Initial ACT was measured after sheath insertion and final ACT was measured before sheath removal. Patients were categorized into complete and incomplete hemostasis groups based on achieving complete hemostasis within two hours of continuous compression. Results: Incomplete hemostasis occurred in 230 patients (18%). Initial and final ACT values were significantly higher in the incomplete hemostasis group compared to the complete hemostasis group (initial ACT: 146 ± 37 s vs. 136 ± 32 s, p < 0.001; final ACT: 259 ± 85 s vs. 243 ± 72 s, p = 0.015). Multivariate analysis revealed that prolonged initial ACT (OR, 2.41; 95% CI, 1.71–3.39; p < 0.001) and final ACT (OR, 2.25; 95% CI, 1.52–3.30; p < 0.001) were independently significant predictors. Conclusions: Initial and final ACT measurements add predictive value to conventional risk factors for incomplete hemostasis in patients undergoing TRA intervention.
Keywords: activated clotting time, incomplete hemostasis, trans-radial coronary intervention, Radial artery occlusion, hemostasis management
Received: 22 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Ahn, Shin, Lee, Kim, Yu, Bae, Cho, Jang, Park and Kwak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jong-Hwa Ahn, jonghwaahn@naver.com
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