Pressure Monitoring-Augmented Long-Axis In-Plane Versus Long-Axis In-Plane Alone for Ultrasound-Guided Radial Artery Catheterization in Elderly Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Prospective Trial
Abstract
OBJECTIVES
Radial artery catheterization is challenging in patients with poor vascular conditions, particularly those with severe atherosclerotic changes. The long-axis in-plane ultrasound technique provides full visualization and reduces the risk of posterior vessel wall injury; however, its precision is compromised by slice-thickness artifacts inherent to ultrasound beam physics. The authors hypothesized that combining pressure monitoring with ultrasound-guided long-axis in-plane catheterization would improve first-attempt success by mitigating ultrasound beam-thickness artifacts.
DESIGN
Single-center prospective randomized controlled study.
SETTING
Tertiary academic cardiac hospital.
PARTICIPANTS
One hundred eight elderly patients scheduled for coronary artery bypass grafting were enrolled, with 54 patients allocated to each study group. Nine junior anesthesiologists performed the procedures after standardized training.
INTERVENTIONS
Patients were randomly assigned to 2 groups: pressure monitoring combined with ultrasound-guided long-axis in-plane catheterization (intervention group) and long-axis in-plane ultrasound-guided catheterization alone (control group).
MEASUREMENTS AND MAIN RESULTS
The primary outcome was the first-attempt success rate; secondary outcomes included procedural time, overall success rate, number of attempts, and complication rate. The intervention group showed a higher first-attempt success rate (74.07% [40 of 54] v 53.70% [29 of 54]; difference,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 54 participants or records.
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