Radial Artery Access With Ultrasound Trial

Study Overview
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Brief Summary
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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.

Official Title
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Radial Artery Access With Ultrasound Trial

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Procedure: Ultrasound guidance
* Procedure: Palpation


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Palpation<br>Manual palpation of radial pulse, as sole guide to needle cannulation. | Procedure: Palpation<br>* Manual palpation for localizing radial artery for inserting needle.<br>|
| Experimental: Ultrasound<br>Real-time ultrasound guidance to facilitate needle cannulation of artery. | Procedure: Ultrasound guidance<br>* Real time ultrasound guidance using ultrasound probe covered in sterile plastic, visualizing radial artery while needle passage attempted.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | Immediately during procedure. (up to 30 minutes) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | Immediately during procedure (within 30 minutes) | 
| First-pass Success Rate | Proportion of procedures achieving access on the first attempt | Immediate | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Transradial catheterization, Ultrasound, Radial artery