Radial Artery Access With Ultrasound Trial

University of California, Irvine698 enrolled

Overview

Radial artery access for cardiac catheterization can require multiple attempts. Multiple attempts increase the time required, patient discomfort, and the risk of arterial spasm. Ultrasound guidance has been shown in other studies to reduce the number of attempts and complications in central venous and femoral artery access. This study will test if the addition of ultrasound guidance reduces the number of attempts and time required to access the radial artery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

698

Conditions

Coronary Artery Disease

Interventions

Ultrasound guidancePROCEDURE

Real time ultrasound guidance using ultrasound probe covered in sterile plastic, visualizing radial artery while needle passage attempted.

PalpationPROCEDURE

Manual palpation for localizing radial artery for inserting needle.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients presenting for cardiac or peripheral catheterization with planned radial approach. * Barbeau's or Allen's test indicating at least some degree of collateral circulation in palmar vessels * Functional ultrasound equipment with ultrasound trained attending operator Exclusion Criteria: * Inability to provide informed consent * Femoral access * Emergency procedure (Shock, STEMI) * End-stage renal disease on hemodialysis * Previous ipsilateral puncture within 1 week

Locations (6)

Long Beach VA Medical Center

Long Beach, California, United States

University of California Irvine Medical Center

Orange, California, United States

Baptist Hospital of Miami

Miami, Florida, United States

Jamaica Hospital

Jamaica, New York, United States

Outcomes

Primary Outcomes

Number of Attempts

Number of passes of the needle required to access the artery during the cardiac catheterization procedure. This is only assessed at the time of the procedure, i.e. during the first 30 minutes. This is to be reported as both total number of attempts and as a first pass success rate.

Time frame: Immediately during procedure. (up to 30 minutes)

Secondary Outcomes

Time to Sheath Insertion (Seconds)

Time from initiation of vascular access attempts to successful aspiration or flushing of the sheath. Time for lidocaine administration, palpation of pulse, or imaging is excluded.

Time frame: Immediately during procedure (within 30 minutes)

First-pass Success Rate

Proportion of procedures achieving access on the first attempt

Time frame: Immediate

Data from ClinicalTrials.gov

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