Radial artery cannulation is a routine procedure for invasive hemodynamic monitoring for patients undergoing cardiovascular surgery patients.
Although ultrasound (USG) guidance is known to improve success rates, there is limited data comparing the efficacy of the 'Direct' versus 'Seldinger' techniques specifically in patients with anticipated difficult radial access.
This study aims to compare the effectiveness of USG-guided Direct cannulation and USG-guided Seldinger techniques in adult patients with anticipated difficult radial arterial cannulation.
Patients aged 18 years or older
American Society of Anesthesiologists (ASA) physical status I-IV
Patients scheduled for cardiovascular surgery requiring invasive arterial monitoring
Patients undergoing emergency surgery
Coagulation disorders or known coagulopathy
Presence of an arteriovenous fistula
Patients in shock or hemodynamically instable
Parallel
Ultrasound-Guided Direct Cannulation Technique
Procedure/SurgeryRadial artery cannulation performed using the direct puncture technique (catheter-over-needle) under real-time ultrasound guidance.
Ultrasound-Guided Seldinger Cannulation Technique
Procedure/SurgeryRadial artery cannulation performed using the Seldinger technique (catheter-over-guide-wire) under real-time ultrasound guidance.
First-Attempt Cannulation Success Rate
The proportion of patients in whom radial artery cannulation is successfully performed (verified by the appearance of the arterial pressure waveform on the monitor) with a single skin puncture
Number of Cannulation Attempts
The total number of skin punctures required to achieve successful radial artery cannulation
Radial artery cannulation time
Total time elapsed from the initial skin contact with the arterial cannula to the visualization of the arterial waveform on the monitor.
Incidence of Procedure-Related Complications
Evaluation of adverse events associated with the cannulation procedure, including hematoma, arterial dissection, posterior wall injury, nerve injury, or infection
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