title: Feasibility and safety of antegrade radial artery cannulation.
abstract: OBJECTIVE
  The purpose of this study was to compare thrombosis rates in antegrade (catheter directed toward the hand) versus retrograde (catheter directed toward the elbow) cannulation of the radial artery. Our secondary objectives were to compare these two techniques in terms of success rate, differences in noninvasive versus invasive blood pressure measurement and complications.
  
  
  METHODS
  After obtaining the approval of the local ethics committee and written informed consent, the patients were randomly allocated to the antegrade (group A, n=60) or retrograde (group R, n=60) groups. Arterial thrombosis was evaluated by ultrasonography in each patient. Noninvasive and invasive blood pressure measurements and complications were recorded. Data were analysed using Student's t-test, the Mann-Whitney U-test, the categorical chi test, Fisher's exact test and Bland-Altman analysis.
  
  
  RESULTS
  Thrombosis rates were similar between groups. The success rates for cannulation were 86.7 and 96.7% in the antegrade and retrograde groups, respectively (P<0.05). Complication rates were similar between groups. Very significant correlation was observed between the invasive and noninvasive methods when simultaneously measuring arterial systolic, diastolic and mean blood pressure. However, antegrade arterial measurements were consistently lower than those obtained via noninvasive methods.
  
  
  CONCLUSIONS
  We conclude that antegrade radial artery cannulation has no advantage over the retrograde approach in terms of reducing thrombosis, but it can be used in cases when the retrograde approach has failed.
authors.affiliation: Department of Anaesthesiology, Ondokuz Mayis University School of Medicine, Kurupelit, Samsun, Turkey. skaracalar@yahoo.com
authors.forename: Serap
authors.initials: S
authors.lastname: Karacalar
authors.forename: Meltem
authors.initials: M
authors.lastname: Ceyhan
authors.forename: Ilkay Koray
authors.initials: IK
authors.lastname: Bayrak
authors.forename: Seda
authors.initials: S
authors.lastname: Yegin
authors.forename: Binnur
authors.initials: B
authors.lastname: Sarihasan
authors.forename: Hasan Tahsin
authors.initials: HT
authors.lastname: Keceligil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization; D001026:Coronary Artery Bypass / Q000379:methods*; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013927:Thrombosis / Q000000981:diagnostic imaging; D014463:Ultrasonography