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Needle versus cannula over needle for radial artery cannulation during transradial coronary angiography and
Michael Koutouzis1, Andreas Kaoukis2, Michalis Hamilos3
1Department of Cardiology, Red Cross General Hospital.
Insights
Needle versus cannula over needle techniques for radial artery cannulation during transradial procedures showed similar efficacy and safety. Both methods resulted in comparable rates of successful sheath insertion and complication incidence.
Area of Science:
- Cardiology
- Vascular Access Techniques
- Interventional Cardiology
Background:
- Transradial coronary angiography and intervention are standard procedures.
- Radial artery cannulation is the initial step, with various techniques available.
- Optimizing radial artery cannulation is crucial for procedural success and patient safety.
Purpose of the Study:
- To compare the efficacy and safety of two radial artery cannulation methods: needle versus cannula over needle.
- To evaluate the primary endpoint of switching access site or cannulation method due to failed insertion.
- To assess secondary endpoints including procedure time, number of attempts, and safety outcomes.
Main Methods:
- A randomized controlled trial involving 500 patients undergoing transradial catheterization.
- Patients were assigned to either the needle or cannula over needle group for radial artery cannulation.
- The primary endpoint was defined as the need to switch to another access site or cannulation technique.
Main Results:
- No significant difference was observed in the primary endpoint between the needle (4.8%) and cannula over needle (5.6%) groups (p=0.695).
- Cannulation success rates, access site or method switching, cannulation time, procedure duration, number of attempts, and skin punctures were similar between groups.
- Safety endpoints, including radial hematomas and radial artery occlusion, showed no significant differences between the two techniques.
Conclusions:
- Radial artery cannulation using a needle or cannula over needle technique demonstrates comparable efficacy and safety profiles.
- Both methods are suitable for transradial coronary angiography and intervention.
- The choice between needle and cannula over needle may not significantly impact procedural outcomes or patient safety.
Purpose:
To evaluate the efficacy of radial artery cannulation with needle versus cannula over needle during transradial coronary angiography and intervention.
Methods:
Five hundred patients scheduled to undergo transradial catheterization were randomized between the two methods. Primary endpoint of the study was the combined endpoint of switching to another access site due to inability of successful sheath insertion or switching to another method of cannulation (from needle to cannula over needle and vice versa).
Results:
The primary end point was met in 12 patients (4.8%) from the needle group and 14 patients (5.6%) from the cannula over needle group (p=0.695). There were no differences in switching of cannulation method [10 (4.0%)% versus 11 (4.4%), p=0.831], switching of access site [6 (2.8%) versus 9 (3.6%), p=0.441), time for artery cannulation [1.20 (0.80-2.20) min versus 1.26 (1.01-2.39) min, p=0.152], total procedure time [15.05 (9.47-29.03) min versus 19.14 (10.13-32.02) min, p=0.112] number of attempts [2 (1-4) versus 2 (1-5), p=0.244] and number of skin punctures [1 (1-2) versus 1 (1-2), p=0.399] before successful radial artery cannulation. There were no differences recorded in the safety endpoints of EASY grade III or more radial hematomas [2 (0.8%) versus 1 (0.4%), p=1.000] or the incidence of radial artery occlusion after the procedure [9 (3.6% versus 16 (6.8%), p=0.358].
Conclusion:
Radial artery cannulation with needle and cannula over needle seems to be equal in terms of efficacy and safety.
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