Comparing Two Distal Radial Hemostatic Devices for Radial Artery Patency Post-TACE: A Randomized Trial

PURPOSE: To compare the patency outcomes and safety profile between the modified TR Band and the PreludeSYNC DISTAL (PSD) for hemostasis following distal transradial access (dTRA) for transarterial chemoembolization (TACE). METHODS: This prospective randomized trial enrolled 104 participants undergoing TACE via dTRA (143 procedures, all performed using a 4-Fr catheter. Participants achieved hemostasis with either the modified TR Band (n = 74) or PSD (n = 69). The primary endpoint was the incidence of radial artery occlusion (RAO) assessed by Doppler ultrasonography at 4 h, 24 h, and > 1 week. Outcome assessors were blinded. Secondary endpoints included hemostatic performance and complications. RESULTS: No complete RAO occurred in either group (0/143). Partial RAO (mural thrombus with preserved flow) peaked at 4 h (TR Band: 28.4% vs. PSD: 18.8%; risk difference 9.5%, 95% CI -4.3 to 23.3%, p = 0.181) and declined to 4.1% vs. 2.9% by final follow-up (p = 1.000), representing a spontaneous resolution rate of 85.3%. Generalized estimating equations showed no significant difference in overall incidence. The TR Band group had a numerically higher rate of delayed hemostasis (> 4 h) compared with PSD (5.4% vs. 0.0%, p = 0.121). Complication rates (hematoma, pseudoaneurysm) did not differ significantly. CONCLUSION: The modified TR Band and PSD demonstrated comparable rates of partial radial artery occlusion and access-site complications following dTRA for TACE.