Effects of Compression of the Ulnar Artery on the Radial Artery Catheterization

Background: The study was designed to evaluate the effects of compression of the ulnar artery on blood flow (BF) and internal cross-sectional area (CSAi) of the radial artery. We also evaluated the success rate and time of successful ultrasound-guided radial artery catheterization at the first attempt with or without compression of the ulnar artery. Methods: Patients were randomly allocated to the Compression group or Standard group to be treated with or without the application of ulnar artery compression, respectively. Hemodynamic stability was confirmed, and ultrasound-guided radial artery catheterization was performed. In the Compression group, an assistant compressed the ulnar artery at 5 cm above the wrist crease and the catheterization was performed after the loss of the distal ulnar artery BF. In the Standard group, the catheterization was performed without compression of the ulnar artery. Before and after the catheterization, BF and CSAi of the radial artery were evaluated. Success rate and time to successful catheterization at the first attempt were recorded. Results: BF and CSAi of the radial artery were similar in the two groups (37.5 [19.3−66] vs. 37.0 [20.6−53.7] mL/min, respectively, p = 0.63; 4.0 [4.0−6.0] vs. 4.0 [3.0−5.0] mm2, respectively, p = 0.095). In the Compression group, BF and CSAi were changed to 80.9 [35.9−128.5] mL/min (p < 0.001) and 5.0 [4.0−7.0] mm2 (p < 0.001), respectively, after compression of the ulnar artery. There was a trend that the success rate of ultrasound-guided radial artery catheterization at the first attempt was higher in the Compression group than in the Standard group (58/59 vs. 53/59, respectively, p = 0.05), although the difference was not statistically significant. However, the time to successful ultrasound-guided radial artery catheterization at the first attempt was significantly shorter in the Compression group than in the Standard group (34 [27−41] s vs. 46 [36−60] s, p < 0.001). Conclusion: Compression of the ulnar artery augmented BF and CSAi of the radial artery. It resulted in a significantly shorter success time for ultrasound-guided radial artery catheterization at the first attempt.