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Updated: Jun 21, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Ultrasound-guided vs. Standard Coronary Access in Coronary Angiography: A Systematic Review and Meta-analysis
Ibrahim Omer1,2, Mohammed Bukhari1,2, Mohammad Alsharif3
1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Insights
Ultrasound guidance during coronary artery catheterization significantly reduces procedural complications like hematoma formation. This safer approach improves patient outcomes and supports wider clinical adoption.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Procedures
Background:
- Coronary angiography is crucial for diagnosing coronary artery disease (CAD).
- Traditional landmark-based vascular access carries risks.
- Ultrasound offers a potentially safer, accessible alternative for guiding catheterization.
Purpose of the Study:
- To evaluate the efficacy and safety of ultrasound-guided coronary artery catheterization.
- To compare complication rates between ultrasound-guided and landmark-based approaches.
Main Methods:
- Systematic review and meta-analysis of 10 randomized controlled trials (RCTs).
- Adherence to PRISMA guidelines.
- Independent data extraction by two reviewers.
Main Results:
- Ultrasound-guided catheterization significantly reduced total complications (RR=0.53).
- A significant reduction in hematoma >5 cm formation was observed (RR=0.43).
- Statistical significance was confirmed for both outcomes (P < .001 and P = 0.003, respectively).
Conclusions:
- Ultrasound-guided catheterization improves peri-catheterization outcomes compared to landmark-based methods.
- The findings support the consideration of ultrasound guidance in clinical practice.
- Further research is warranted to solidify its role.
Objectives:
Coronary angiography is a procedure performed during cardiac catheterization to define the coronary anatomy and determine the extent of coronary artery disease (CAD). The use of a cheap, relatively available tool like an ultrasound machine to assist in vascular access might reduce the risks associated with blind access. This study aimed to explore the efficacy and associated complications of ultrasound-guided coronary artery catheterization.
Methods:
This systematic review of randomized controlled trials (RCTs) was conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in PROSPERO (CRD42022365518). A systematic search was performed for all published studies without language or country restrictions and all study variables were extracted into prefilled sheets by two independent reviewers.
Results:
This meta-analysis identified 10 RCTs. The results confirmed statistically significantly reductions of total complications (RR = 0.53, 95% CI 0.39-0.72, P < .001), and hematoma >5 cm formation (RR = 0.43, 95% CI 0.25-0.75, P = 0.003) in patients who underwent ultrasound-guided coronary artery catheterization.
Conclusion:
Ultrasound with catheterization, as opposed to landmark-based catheterization, significantly improved the peri-catheterization operative outcomes, providing evidence for further research to be conducted and consideration for its implementation within the medical setting.
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