Radial artery cannulation: a comparison of 15.2- and 4.45-cm catheters

Eighty-nine patients were studied prospectively to compare the incidence of postdecannulation arterial thrombosis and ischemic complications associated with percutaneous insertion of two different radial artery catheters. Patients scheduled for peripheral vascular surgery were randomized to receive a 15.2-cm (6 in, Argon Medical Corp.) or 4.45-cm (1.75 in, Arrow International, Inc.) 20-gauge, Teflon catheter. Extremity blood flow was evaluated prior to cannulation and again after decannulation with the modified Allen's test, pulse-volume plethysmography, and Doppler ultrasound. The incidence of postdecannulation radial artery occlusion for 15.2-cm catheters was significantly less than for 4.45-cm catheters (4 of 45 cases versus 11 of 44 cases, p = 0.05). No case of temporary or permanent ischemic injury occurred. Radial artery transfixion (16 of 45 cases versus 5 of 44 cases, p = 0.01) and hematoma formation (5 of 45 cases versus 0 of 44 cases, p = 0.02) occurred more frequently during insertion of 15.2-cm catheters than 4.45-cm catheters. The number of arterial punctures during catheter insertion and the duration of cannulation were similar for both groups. Of the 8 patients with positive modified Allen's test who underwent radial artery cannulation, one suffered arterial occlusion. Radial artery cannulation with a 15.2-cm catheter was associated with a lower incidence of postdecannulation radial artery thrombosis than cannulation with the 4.45-cm catheter. Radial artery cannulation with longer catheters (greater than 5.0 cm) appears to be a safe practice.