In vivo hemostasis detection at human femoral arteriotomy by ARFI ultrasound

Noninvasively monitoring hemostasis at femoral artery puncture sites (arteriotomies) could reduce complications associated with percutaneous coronary artery catheterization and reduce medical cost, yet no diagnostic imaging method is proven for this application. In a pilot clinical investigation, ARFI imaging was performed at the femoral arteriotomies of 20 patient volunteers randomized to treatment with standard of care manual compression alone or to manual compression augmented by a hemostatic dressing to expedite time to hemostasis onset. Average ARFIderived times to hemostasis in patient volunteers treated with manual compression alone (n=10) and manual compression augmented by hemostatic dressing (n=9) were, respectively, 13.00 ± 1.56 and 9.44 ± 3.09 min (p ≤ 0.0065, Wilcoxon). ARFI-induced displacements were observed to be larger at arteriotomies and in extravasated blood pools. These data suggest that ARFI imaging is capable of noninvasively monitoring hemostasis onset at femoral arteriotomies.