---
title: "Standardizing Transradial Compression Band Deflation to Reduce Time to Hemostasis and LOS"
id: "pubmed-42619204"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42619204"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42619204/"
doi: "10.1097/AJN.0000000000000367"
published_at: "2026-08-20T18:17:16.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Standardizing Transradial Compression Band Deflation to Reduce Time to Hemostasis and LOS
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42619204
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42619204/)
- **DOI:** [10.1097/AJN.0000000000000367](https://doi.org/10.1097%2FAJN.0000000000000367)
- **Published At:** 2026-08-20T18:17:16.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Transradial access (TRA) is a standard approach for cardiac catheterization; postprocedure hemostasis commonly uses **air-filled compression bands**. Variability in band deflation timing, amount of air removed, and documentation existed at the authors' urban academic center. - A multidisciplinary nursing-led quality improvement used an evidence-based practice (EBP) process to create a standardized **compression band deflation algorithm** and documentation protocol. - Key algorithm elements: initiate deflation at 30 minutes for diagnostic procedures or when patients received ≤5,000 units of **heparin**; initiate at 60 minutes for advanced diagnostics or PCI when patients received >5,000 units of heparin or IV bivalirudin. The algorithm also specified wait times and criteria for reinserting air based on bleeding. - The initiative compared a preintervention group (n = 214) with a postintervention group (n = 255). Groups were comparable for age, sex, procedure type, and anticoagulant use. - After implementation there was a statistically significant reduction in time to successful band removal for both diagnostic procedures and PCI (P < 0.001 for both) and a decrease in **length of stay (LOS)** across procedure types; diagnostic procedures showed a significant LOS reduction (P < 0.001). - Clinical documentation for air removed, air reinserted, and complications improved significantly postintervention (P < 0.001). - Safety outcomes: over 85% of postintervention patients had no recorded complications during band removal; 100% had no major bleeds or hematomas. The project reported no compromise to patient safety with earlier, standardized deflation. - The authors conclude that an early band deflation algorithm can reduce time to band removal and LOS across diagnostic, advanced diagnostic, and PCI procedures while improving documentation and maintaining safety, providing a clinical basis for broader adoption of early compression band deflation for TRA.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 20. # Rethinking Transradial Compression Band Practice [Kristin Ann Tuozzo](https://pubmed.ncbi.nlm.nih.gov/?term=Tuozzo+KA&cauthor_id=42619204)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42619204/#full-view-affiliation-1 "Kristin Ann Tuozzo and Nicole A. Moskowitz are senior nurse clinicians at NYU Langone Health, New York City, where Esther L. Munitz-Pinson is a nurse clinician and Loretta Gioiella is a nurse manager. Sunil V. Rao is medical director of interventional cardiology at the NYU Grossman School of Medicine, New York City, where Louai Razzouk is director of the interventional cardiology training program. Homam Ibrahim is director of structural heart and cardiovascular research at Adventist Healthcare, Silver Spring, MD. The authors acknowledge Tammy Chan, MSN, RN, CCRN, CV-BC, MEDSURG-BC, Aileen Wai, MSN, RN, and Veronica Walker, MS, RN, for serving as subject matter experts on this project. Contact author: Kristin Ann Tuozzo, kristin.tuozzo@gmail.com. The authors have disclosed no potential conflicts of interest, financial or otherwise."), [Esther L Munitz-Pinson](https://pubmed.ncbi.nlm.nih.gov/?term=Munitz-Pinson+EL&cauthor_id=42619204), [Nicole A Moskowitz](https://pubmed.ncbi.nlm.nih.gov/?term=Moskowitz+NA&cauthor_id=42619204), [Loretta Gioiella](https://pubmed.ncbi.nlm.nih.gov/?term=Gioiella+L&cauthor_id=42619204), [Sunil V Rao](https://pubmed.ncbi.nlm.nih.gov/?term=Rao+SV&cauthor_id=42619204), [Louai Razzouk](https://pubmed.ncbi.nlm.nih.gov/?term=Razzouk+L&cauthor_id=42619204), [Homam Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+H&cauthor_id=42619204) Affiliations Expand ### Affiliation * 1 Kristin Ann Tuozzo and Nicole A. Moskowitz are senior nurse clinicians at NYU Langone Health, New York City, where Esther L. Munitz-Pinson is a nurse clinician and Loretta Gioiella is a nurse manager. Sunil V. Rao is medical director of interventional cardiology at the NYU Grossman School of Medicine, New York City, where Louai Razzouk is director of the interventional cardiology training program. Homam Ibrahim is director of structural heart and cardiovascular research at Adventist Healthcare, Silver Spring, MD. The authors acknowledge Tammy Chan, MSN, RN, CCRN, CV-BC, MEDSURG-BC, Aileen Wai, MSN, RN, and Veronica Walker, MS, RN, for serving as subject matter experts on this project. Contact author: Kristin Ann Tuozzo, kristin.tuozzo@gmail.com. The authors have disclosed no potential conflicts of interest, financial or otherwise. * PMID: **42619204** * DOI: [ 10.1097/AJN.0000000000000367 ](https://doi.org/10.1097/ajn.0000000000000367) Item in Clipboard # Rethinking Transradial Compression Band Practice Kristin Ann Tuozzo et al. Am J Nurs. 2026. Show details Display options Display options Format Abstract PubMed PMID Am J Nurs Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Am+J+Nurs%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Am+J+Nurs%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) . 2026 Sep 1;126(9):40-48. doi: 10.1097/AJN.0000000000000367. Epub 2026 Aug 20. ### Authors [Kristin Ann Tuozzo](https://pubmed.ncbi.nlm.nih.gov/?term=Tuozzo+KA&cauthor_id=42619204)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42619204/#short-view-affiliation-1 "Kristin Ann Tuozzo and Nicole A. Moskowitz are senior nurse clinicians at NYU Langone Health, New York City, where Esther L. Munitz-Pinson is a nurse clinician and Loretta Gioiella is a nurse manager. Sunil V. Rao is medical director of interventional cardiology at the NYU Grossman School of Medicine, New York City, where Louai Razzouk is director of the interventional cardiology training program. Homam Ibrahim is director of structural heart and cardiovascular research at Adventist Healthcare, Silver Spring, MD. The authors acknowledge Tammy Chan, MSN, RN, CCRN, CV-BC, MEDSURG-BC, Aileen Wai, MSN, RN, and Veronica Walker, MS, RN, for serving as subject matter experts on this project. Contact author: Kristin Ann Tuozzo, kristin.tuozzo@gmail.com. The authors have disclosed no potential conflicts of interest, financial or otherwise."), [Esther L Munitz-Pinson](https://pubmed.ncbi.nlm.nih.gov/?term=Munitz-Pinson+EL&cauthor_id=42619204), [Nicole A Moskowitz](https://pubmed.ncbi.nlm.nih.gov/?term=Moskowitz+NA&cauthor_id=42619204), [Loretta Gioiella](https://pubmed.ncbi.nlm.nih.gov/?term=Gioiella+L&cauthor_id=42619204), [Sunil V Rao](https://pubmed.ncbi.nlm.nih.gov/?term=Rao+SV&cauthor_id=42619204), [Louai Razzouk](https://pubmed.ncbi.nlm.nih.gov/?term=Razzouk+L&cauthor_id=42619204), [Homam Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+H&cauthor_id=42619204) ### Affiliation * 1 Kristin Ann Tuozzo and Nicole A. Moskowitz are senior nurse clinicians at NYU Langone Health, New York City, where Esther L. Munitz-Pinson is a nurse clinician and Loretta Gioiella is a nurse manager. Sunil V. Rao is medical director of interventional cardiology at the NYU Grossman School of Medicine, New York City, where Louai Razzouk is director of the interventional cardiology training program. Homam Ibrahim is director of structural heart and cardiovascular research at Adventist Healthcare, Silver Spring, MD. The authors acknowledge Tammy Chan, MSN, RN, CCRN, CV-BC, MEDSURG-BC, Aileen Wai, MSN, RN, and Veronica Walker, MS, RN, for serving as subject matter experts on this project. Contact author: Kristin Ann Tuozzo, kristin.tuozzo@gmail.com. The authors have disclosed no potential conflicts of interest, financial or otherwise. * PMID: **42619204** * DOI: [ 10.1097/AJN.0000000000000367 ](https://doi.org/10.1097/ajn.0000000000000367) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Transradial access (TRA) is a standard approach to cardiac catheterization. Following the procedure, air-filled compression bands are often used to achieve hemostasis at the access site. Despite research supporting early, gradual deflation to minimize complications, there is no established best practice for band deflation. At our urban academic medical center, the lack of a standardized compression band deflation protocol resulted in varied start times and amounts of air removed with each attempt, as well as inconsistent documentation. **Purpose:** The aim of this quality improvement project was to develop and implement an evidence-based practice (EBP) initiative to standardize TR compression band deflation and documentation. **Methods:** Nurses, who were primarily responsible for the TRA procedure, organized a multidisciplinary team to critically evaluate the literature, identify gaps in clinical practice, and develop and implement a practice change. EBP interventions centered on a TR compression band deflation algorithm that included specified wait times based on the procedure type and anticoagulation received and the criteria for reinserting air based on bleeding status. A standardized documentation process was also instituted. Deflation was initiated at 30 minutes for patients undergoing diagnostic procedures or receiving up to 5,000 units of heparin and at 60 minutes for patients undergoing advanced diagnostic procedures or percutaneous coronary intervention (PCI) and receiving more than 5,000 units of heparin or IV bivalirudin. Demographics, documentation, complications, time to remove the compression band, length of stay (LOS), patient satisfaction, and opportunity benefit were analyzed. **Results:** The preintervention (n = 214) and postintervention (n = 255) groups were comparable in age, gender distribution, procedure type, and anticoagulant use. Following the rollout of the EBP initiative, there was a statistically significant reduction in the time required for successful compression band removal for both diagnostic procedures (P < 0.001) and PCIs (P < 0.001). LOS decreased across all procedure types. Specifically, diagnostic procedures had a statistically significant postintervention reduction in LOS (P < 0.001). In addition, clinical documentation (encompassing air removed, air reinserted, and complications) showed significant postintervention improvement (P < 0.001). Regarding safety outcomes, over 85% of patients in the postintervention group experienced no recorded complications during band removal, while 100% had no major bleeds or hematomas. **Conclusions:** This EBP initiative confirms that an early band deflation algorithm reduces time for band removal and LOS across diagnostic, advanced diagnostic, and PCI procedures without compromising patient safety. Furthermore, the initiative improved documentation, ensuring consistent monitoring and nursing transitions. These findings provide a clinical basis for adopting early compression band deflation for TRA procedures. **Keywords:** cardiac catheterization; compression band deflation; hemostasis; length of stay; transradial access. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. Mason PJ, Shah B, Tamis-Holland JE, et al. An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association. Circ Cardiovasc Interv. 2018;11(9):e000035. doi:10.1161/hcv.0000000000000035 2. 1. Bernat I, Aminian A, Pancholy S, et al. Best practices for the prevention of radial artery occlusion after transradial diagnostic angiography and intervention: an international consensus paper. JACC Cardiovasc Interv. 2019;12(22):2235–2246. doi:10.1016/j.jcin.2019.07.043 3. 1. da Silva RL, de Andrade PB, Abizaid AAC, et al. Comparison of minimum pressure and patent hemostasis on radial artery occlusion after transradial catheterization. J Invasive Cardiol. 2020;32(4):147–152. doi:10.25270/jic/19.00372 4. 1. Kanal Y, Özkan C. The relationship between amount of air supplied to radial artery compression device used after transradial procedure and radial artery stenosis. Acta Cardiol Sin. 2024;40(2):200–207. 5. 1. Kheirabad MK, Mohebbi Z, Kalyani MN, Kojuri J. Vascular outcomes of early deflation of radial artery band following coronary angiography: a controlled clinical trial. J Vasc Nurs. 2023;41(2):56–61. doi:10.1016/j.jvn.2023.04.001 Show all 26 references ## MeSH terms * Cardiac Catheterization* / methods Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cardiac+Catheterization%2Fmethods%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cardiac+Catheterization) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Compression Bandages* / standards Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Compression+Bandages%2Fstandards%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Compression+Bandages) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Evidence-Based Practice Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Evidence-Based+Practice%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Evidence-Based+Practice) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Hemorrhage* / prevention & control Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hemorrhage%2Fprevention+and+control%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Hemorrhage) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Quality Improvement Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Quality+Improvement%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Quality+Improvement) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) * Radial Artery* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Radial+Artery%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Radial+Artery) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42619204/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42619204/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42619204%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42619204/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42619204%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42619204%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42619204/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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