Oblique approach for ultrasound-guided radial artery catheterization vs transverse and longitudinal approaches, a randomized trial

Study objective To investigate the value of using a new technique for ultrasound-guided radial artery catheterization; oblique approach; vs transverse and longitudinal views are the traditionally used approaches aiming to combine benefits and avoid drawbacks of aforementioned approaches. Design A prospective randomized nonblinded study. Setting Gastroenterology Center, Mansoura University, Egypt from February 2015 to August 2015. Patients One hundred twenty-six surgical and intensive care unit patients indicated for arterial catheterization. Intervention Patients were randomly allocated into 3 groups according to the US-guided technique used; group T (n = 42) using transverse view, group L (n = 42) using longitudinal view, group O (n = 42) using oblique view. Measurements Primary objective was overall success rate; secondary objectives were first attempt success, time to cannulate, and operator satisfaction with the used technique. Main results Forty-two patients were included for each study group. Overall success rate of radial artery catheterization was significantly higher in group O than in group T and clinically higher than group L (60% for group T, 70% for group L, 90% for group O; P < .02). Likewise, time needed to cannulate the radial artery was significantly lower in group O than in both group T and group L (28 ± 19 s for group T, 66 ± 5 s for group L, 16 ± 7 s for group O; P < .00]. Conclusion These results support the conclusion that the oblique approach for US-guided radial artery catheterization may replace the 2 classic approaches owing to its superior success rate, higher first attempt success and shorter time consumed for catheterization with more operator satisfaction after the procedure.