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VOLUME 3 , ISSUE 1 ( January-April, 2024 ) > List of Articles

Original Article

Ultrasound-guided In-plane vs Out-of-plane Approach for Radial Arterial Cannulation after Transradial Cardiac Catheterization: A Randomized Prospective Study

Sucharita Das, Vinay P, Sharanya Majumdar

Keywords : Coronary artery bypass grafting, Long-axis in-plane, Short-axis out-of-plane, Transradial artery catheterization, Ultrasonography

Citation Information : Das S, P V, Majumdar S. Ultrasound-guided In-plane vs Out-of-plane Approach for Radial Arterial Cannulation after Transradial Cardiac Catheterization: A Randomized Prospective Study. 2024; 3 (1):8-11.

DOI: 10.5005/jp-journals-10089-0107

License: CC BY-NC 4.0

Published Online: 30-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Arterial cannulation is a common and essential procedure that is necessary for obtaining arterial blood samples and continuously monitoring blood pressure. However, there may be difficulties with cannulating the radial artery (RA) after the RA has been used for transradial catheterization for coronary angiography in patients in patients scheduled for cardiac surgery. This study's main goal was to compare the ease of RA cannulation following a previous transradial catheterization for diagnostic purposes using ultrasound (US) by utilizing two distinct approaches—the in-plane (long-axis) method and the out-of-plane (short-axis) method. Materials and methods: In a prospective observational study, patients who underwent coronary artery bypass grafting (CABG) surgery after transradial catheterization for coronary angiography were randomly allocated to one of two groups—(1) the short-axis out-of-plane (SA-OOP) group or (2) the long-axis in-plane (LA-IP) group. Using US to compare the two methods, the following parameters were taken into account—(1) success rate of the first pass, (2) time it took for ultrasonic localization, (3) anteroposterior arterial diameter, (4) distance between the skin and the artery, (5) total number of attempts, (6) cannulation time, (7) procedure-related complications; (8) failure rate, and (9) number of cannulas used. Results: The 116 participants in our study were divided into two groups—the 58 members of the SA-OOP group and the 58 members of the LA-IP group. Cannulation proved to be successful in 110 of the 116 patients. A total of 56 of 58 patients in the LA-IP group were successfully cannulated, compared to 54 of 58 patients in the SA-OOP group. The mean ultrasonic localization time in the SA-OOP group was 6.87 ± 2.5 seconds [mean ± standard deviation (SD)], and that in the LA-IP group was 18.18 ± 2.3 (mean ± SD), the difference was statistically significant. The occurrence of posterior wall damage as a complication was significantly higher in the SA-OOP group (10/54) than in the LA-IP group (2/56). There were no significant differences in time taken for cannula insertion, skin-to-artery distance, arterial diameter, number of attempts, number of cannulas used, other complications, and first-pass success rate. Conclusion: The findings of this study suggest that the LA-IP technique is more efficient than the SA-OOP technique for RA cannula insertion after a previous transradial artery catheterization.

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