A novel balloon pressure monitoring technique presented at the European Society of Cardiology Congress 2025 was associated with improved efficiency in achieving hemostasis after transradial coronary angiography without compromising safety.

Radial artery occlusion (RAO) remains a recognized complication of transradial procedures, with reported incidence ranging from 1% to 10%. Conventional hemostasis approaches often require repeated assessment and manual pressure adjustment. A balloon-based strategy was evaluated that enables continuous monitoring and titration of compression pressure to maintain radial artery patency.

In this single-center randomized controlled trial, an interim analysis of 390 of a planned 818 patients was conducted. Participants were randomized to balloon pressure monitoring or standard volume-guided hemostasis. The primary endpoint was 24-hour RAO confirmed by ultrasound. Secondary endpoints included bleeding complications, hemostasis time, and personnel requirements.

RAO incidence was low and similar between groups (2.1% vs. 1.5%; p>0.05). Balloon monitoring was associated with a shorter median hemostasis time (98 vs. 180 seconds; p<0.001) and reduced personnel requirement (one vs. two operators). Multivariable analysis indicated that shorter compression time was associated with lower bleeding risk, while diabetes was associated with increased bleeding risk.

These findings suggest that balloon pressure monitoring provides comparable safety to standard care while improving procedural efficiency. Final results from the full cohort are awaited, and the approach may have practical relevance in resource-limited catheterization laboratory settings.