ASFO TR Band Removal Protocol

In our Cath Lab, the use of TR Band is now routine for achieving hemostasis following radial artery puncture, either right or left, following diagnostic and/or interventional procedures. The TR BAND management is primarily nursing: the green marker on the device balloon is placed about 0.5-1 cm above the site of the arterial puncture, and as the sheath (usually between 5 to 7 Fr) is withdrawn the nurse inflates the balloon until hemostasis is achieved, which occurs on average around 15 mL. The radial pulse is assessed both proximally and distally to ensure radial artery patency. Thereafter, the patient will be followed by a nurse from the Cardiology Unit who will deflate the balloon in defined steps: - First step is after 2 hours deflating 4 mL - Second step after a further two hours deflating another 4 mL - Third and last step after 30 min deflating the remaining 7 mL At each step the nurse makes sure that no blood loss appears, no hematoma forms, and that the pulse is present. At the third step, if hemostasis is achieved, TR BAND can be removed and the reverse Barbeau Test can be performed to ensure the radial artery is patent.

The green marker on the device balloon is placed about 0.5-1 cm above the arterial puncture site, and as the sheath is withdrawn, the nurse inflates the balloon until hemostasis is achieved, which occurs on average around 15 mL, making sure the radial pulse is assessed both proximally and distally. If hemostasis isn't achieved at that volume, the balloon is inflated mL by mL until the result is achieved.