Ultrasound-guided radial artery access by a non-ultrasound trained interventional cardiologist improved first-attempt success rates and shortened time for successful radial artery cannulation.

BACKGROUND: Use of the radial artery for cardiac catheterization and percutaneous coronary intervention (PCI) continues to expand. Cannulating the radial artery can be one of the most challenging aspects of the radial approach. Ultrasound-guided vascular access may be a method to improve first-attempt success rates and shorten time to radial artery access.
METHODS: Fifty consecutive patients underwent ultrasound-guided radial artery access (UGRAA) by a senior interventional cardiologist with little prior experience with UGRAA. The operator had 20 run-in cases before enrolling subjects. Time to establish access and number of attempts required for each patient were recorded. Ultrasound was also used to measure radial arterial diameter and the distance between the skin and the anterior wall of the radial artery.
RESULTS: All patients had successful UGRAA, 80% on the first attempt and 92% on the first or second attempt. The median time for access was 35 seconds, with an interquartile range of 31-55 seconds.
CONCLUSION: UGRAA improved first-attempt success rates and shortened the time needed for radial artery cannulation when compared to historical data of palpation-directed radial artery access. A large randomized trial of palpation versus UGRAA will be required to confirm this finding. Furthermore, this technique is easy to learn and incorporate into everyday practice in the cardiac catheterization lab.