title: Radial artery access technique evaluation trial: randomized comparison of Seldinger versus modified Seldinger technique for arterial access for transradial catheterization.
abstract: BACKGROUND
  Radial artery access for transradial catheterization is obtained using either Seldinger or modified Seldinger technique. There is no comparative evaluation of the safety and benefits of these two techniques.
  
  
  METHODS
  Four hundred twelve patients undergoing transradial catheterization were randomized to group I (n = 210) Seldinger technique, and group II (n = 202) modified Seldinger technique. Demographic and procedural data were collected at the time of the procedure. Data on hematoma and radial artery occlusion (RAO) were recorded at 24 hr and 30 days after the procedure.
  
  
  RESULTS
  Age, gender, weight, height, and history of diabetes mellitus were comparable between groups I and II. Access time (78.3 ± 37.7 sec vs. 134.2 ± 87.5 sec, P < 0.001), procedure time (17.1 ± 6.4 min vs. 19.3 ± 7.1 min, P < 0.01), number of attempts to get access (1.7 ± 0.8 vs. 2.2 ± 0.8, P < 0.001), were significantly different favoring group I. Access was obtained at first attempt in 53% of patients in group I compared with 16% in group II (P < 0.001). Change in technique (crossover) was required in 10.8% of group II patients, compared with no crossover in group I (P < 0.0001). Incidence of hematoma (0.5% vs. 1.5%, P > 0.2) and 30-day RAO (4.3% vs. 3.9 %, P > 0.5) was similar between groups I and II.
  
  
  CONCLUSIONS
  Seldinger technique is a faster and more predictable radial artery access technique compared with modified Seldinger technique with no increase in bleeding or RAO.
authors.affiliation: Department of Cardiovascular Diseases, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA. pancholys@gmail.com
authors.forename: Samir B
authors.initials: SB
authors.lastname: Pancholy
authors.forename: Kintur A
authors.initials: KA
authors.lastname: Sanghvi
authors.forename: Tejas M
authors.initials: TM
authors.lastname: Patel
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D017534:Radial Artery / Q000293:injuries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D057772:Vascular System Injuries / Q000209:etiology