Real-Time Ultrasound Guidance Facilitates Transradial Access

Seto, Arnold H.; Roberts, Jonathan; Abu‐Fadel, Mazen; Czak, Steven; Latif, Faisal; Jain, Suresh P.; Raza, Jaffar Ali; Mangla, Aditya; Panagopoulos, Georgia; Patel, Pranav; Kern, Morton J.; Lasić, Zoran

doi:10.1016/j.jcin.2014.05.036

Cited by 199 publications

(73 citation statements)

References 19 publications

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“…5,14,20 The application of subcutaneous nitrates and the implementation of ultrasound-guided puncture may facilitate radial artery cannulation and reduce the number of puncture attempts needed to achieve cannulation. 21,22 In addition, we also observed a negative correlation between radial lumen at 30 days and the number of puncture attempts. This might have important consequences for future catheterizations through the same radial access considering that smaller and less pulsatile arteries might be more difficult to cannulate.…”

Section: Discussionsupporting

confidence: 57%

The Rotterdam Radial Access Research

Costa

Leeuwen

Daemen

et al. 2016

Circ: Cardiovascular Interventions

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Background-Radial artery wall might be damaged after cannulation for cardiac catheterization. We investigated structural changes of the radial artery wall after catheterization to understand whether these might predict radial pulsation loss or occlusion and local pain or functional impairment of the upper extremity. Methods and Results-Ninety patients underwent transradial coronary angiography or intervention and were scanned with a high-resolution 40-MHz ultrasound before cannulation and at 3 hours and 30 days after procedure. Acute injuries of the radial artery occurred in all patients: dissection and intramural hematoma were the most common. However, these phenomena did not predict loss of radial pulsation or occlusion, local pain, or functional impairment at 30 days. Overall, the radial artery lumen was significantly reduced distal to the puncture site. Radial artery intima and total wall thickness increased 3 hours after puncture and persisted at 30 days. Radial occlusion and pulsation loss were observed in 3.9% and 9.2% of patients, respectively, at 30 days. Smaller radial artery lumen at baseline increased the risk of radial pulsation loss at 30 days (odds ratio, 1.23; P=0.049). The number of radial puncture attempts predicted pulsation loss (odds ratio, 2.64; P=0.027), occlusion (odds ratio, 3.49; P=0.022), and symptoms (odds ratio, 2.24; P=0.05) at 30-day follow-up. Conclusions-After catheterization, radial artery puncture site is associated with increased intima and total wall thickness and with modest decrease of inner lumen diameter. Acute injuries of the vessel wall were ubiquitous, but contrary to repeated puncture attempts, did not seem to affect postprocedural radial occlusion or loss of pulsation.(Circ Cardiovasc Interv. 2016;9:e003129.

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Section: Discussionsupporting

confidence: 57%

The Rotterdam Radial Access Research

Costa

Leeuwen

Daemen

et al. 2016

Circ: Cardiovascular Interventions

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“…Because there was no previous study on the effect of simulation training in ultrasound-guided radial artery cannulation, sample size was calculated based on the previously reported first attempt success rate in ultrasound-guided radial artery cannulation. The first attempt success rate was 65% in a previous study, [17] while a pilot study in our center involving only novices in ultrasound-guided radial artery cannulation had a first attempt success rate of 35%. Assuming a difference in means of 30% in first attempt success rate between the simulation group and the control group, the necessary minimum sample size PLOS ONE to achieve the desired power of 0.8 and alpha error of 0.05 was 80 artery cannulations (40 per group).…”

Section: Discussionmentioning

confidence: 69%

Simulation-based training using a vessel phantom effectively improved first attempt success and dynamic needle-tip positioning ability for ultrasound-guided radial artery cannulation in real patients: An assessor-blinded randomized controlled study

Oh¹,

Lee²,

Kwon³

et al. 2020

PLoS ONE

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“…In addition, multiple studies have shown that the radial artery can be easily identified via ultrasound 6,8,9. We attempted to show that noninvasive peripheral arterial BP could be similarly assessed using common items found in most EDs.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Radial Artery Compression to Assess Blood Pressure

Bunting

Butki

Sullivan

2017

WestJEM

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IntroductionWe proposed using compression sonography to observe the coaptation and collapse of the radial artery as a surrogate for automated cuff blood pressures (BP). We hypothesize that the pressure required to achieve coaptation and complete collapse of the artery would correlate to the diastolic and systolic BP, respectively. This pilot study was to assess the feasibility of ultrasound-guided radial artery compression (URAC) for BP measurement and compare patient comfort levels during automated cuff with URAC measurements.MethodsThis was a prospective cohort pilot study with a convenience sampling of 25 adult patients at a single urban emergency department. URAC pressure was measured, followed by cuff manometry on the same arm. A 100mL normal saline bag was connected to the Stryker pressure monitor and placed on the volar wrist. Pressure was applied to the bag with a linear transducer and the radial artery was observed for coaptation of the anterior and posterior walls and complete collapse. Pressures required for coaptation and collapse were recorded from the Stryker display. Patient level of comfort was also documented during the URAC method, with patients reporting either “more,” “same” or “less” comfort in comparison to automated cuffs. We analyzed data using intraclass correlation and paired t-tests. Interrater reliability was calculated using intraclass correlation.ResultsThe mean cuff systolic BP was 138.6 ± 22.1 mmHg compared to 126.9 ± 19.8 mmHg for the URAC systolic BP (p=0.02). For diastolic BP, there was no significant difference between the cuff BP and the URAC BP (83.7 ± 13.0 cuff vs. 86.5 ± 19.8 URAC, p=0.46). The intraclass correlation (ICC) for systolic BP was 0.48 (p=0.04) and 0.57 (p=0.02) for diastolic BP. The agreement between the two observers was 0.88 for identifying coaptation on ultrasound (diastolic pressure) and was 0.92 for identifying collapse (systolic pressure). Eighty percent (20/25) of subjects found the URAC method more comfortable than the cuff measurement, and the remainder found it the same (5/20).ConclusionThis pilot study showed statistically significant moderate correlation between automated cuff diastolic BP and URAC measurements for vessel coaptation. Additionally, most patients found the URAC method more comfortable than traditional cuff measurements. Compression ultrasonography shows promise as an alternative method of BP measurement, though future studies are needed.

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Real-Time Ultrasound Guidance Facilitates Transradial Access

Abstract: Ultrasound guidance improves the success and efficiency of radial artery cannulation in patients presenting for transradial catheterization. (Radial Artery Access With Ultrasound Trial [RAUST]; NCT01605292).

Cited by 199 publications

References 19 publications

The Rotterdam Radial Access Research

The Rotterdam Radial Access Research

Simulation-based training using a vessel phantom effectively improved first attempt success and dynamic needle-tip positioning ability for ultrasound-guided radial artery cannulation in real patients: An assessor-blinded randomized controlled study

Ultrasound-Guided Radial Artery Compression to Assess Blood Pressure

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