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Can Children Be Considered for Transradial Interventions?: Prospective Study of Sonographic Radial Artery Diameters
Ahmad Alehaideb1, Winston Ha1, Suzanne Bickford1,2
1Department of Image Guided Therapy (A.A., W.H., S.B., A.A.D., K.B., P.M.), The Hospital for Sick Children, University of Toronto, ON, Canada.
Insights
This study establishes reference ranges for pediatric radial artery diameters, crucial for evaluating transradial interventions in children. Findings show a strong correlation between diameter, age, and weight, providing essential data for clinical decision-making.
Area of Science:
- Pediatric cardiology
- Vascular imaging
- Interventional radiology
Background:
- Transradial intervention offers advantages over traditional approaches, including reduced complications and improved patient satisfaction.
- Limited data exists on transradial intervention in pediatric populations due to concerns about pediatric arterial size.
- This study aims to address this gap by measuring radial artery diameters in children.
Purpose of the Study:
- To establish normative reference ranges for radial artery diameters in children across all age groups.
- To provide data that can inform the clinical use of transradial interventions in pediatric patients.
- To lay the groundwork for future trials investigating the safety and efficacy of transradial procedures in children.
Main Methods:
- A prospective study involving 134 children (≤18 years) measured radial artery diameters using ultrasound.
- Participants were categorized into specific age groups (≤2, 3-5, 6-8, 9-11, 12-14, 15-18 years) and pre-/post-adolescent groups.
- Bilateral measurements were taken, yielding 268 data points with high inter-reader agreement (0.95).
Main Results:
- The mean radial artery diameter was 1.86±0.44 mm, with no significant differences between sexes or sides.
- Radial artery diameter strongly correlated with both age (R=0.75) and weight (R=0.74).
- Arterial growth showed a linear increase in early childhood, plateauing to adult sizes in adolescence.
Conclusions:
- Reference ranges for pediatric radial artery diameters are now available for clinical decision-making.
- This data supports the potential for transradial intervention in children.
- Further trials are warranted to establish the clinical safety and efficacy of transradial interventions in pediatric populations.
Background:
Transradial intervention is increasingly replacing approaches, due to lower access complications, cost, and improved patient satisfaction. There are limited supporting data in the pediatric literature, largely due to concerns regarding arterial size. The objective of this study was to measure radial artery diameters in children across all age groups, to establish reference ranges for clinical use.
Methods:
This prospective study was carried out in children ≤18 years of age who underwent ultrasound for measuring radial artery diameters from November 2018 to November 2019. The cohort was divided into age groups: ≤2, 3 to 5, 6 to 8, 9 to 11, 12 to 14, 15 to 18 years, and into pre- and post-adolescent (≥12 years) groups.
Results:
One hundred thirty-four children (M:F=63:71) were included, with bilateral measurements resulting in 268 data points. Mean age was 8.9±5.8 years (range, 29 days to 18 years), mean weight 37.2±27.5 kg (range, 1.7-149.1 kg). Mean-corrected radial artery diameter was 1.86±0.44 mm. There was no difference in arterial diameters between males and females (1.90±0.50 versus 1.81±0.53 mm; P=0.73) or between right and left sides (1.87±0.46 versus 1.87±0.47, P=0.98). There was a strong correlation of diameter with age (R=0.75; P<0.00001) and weight (R=0.74; P<0.00001). There was linear increase in arterial growth rates in early childhood, followed by plateauing to adult sizes in adolescents. Inter-reader agreement was 0.95.
Conclusions:
We provide a reference range for radial artery diameters across childhood ages, which can be used for decision-making. This could be the basis for designing a trial of transradial intervention in children, to establish clinical safety and efficacy.
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