title: Effect of bevel direction on the success rate of ultrasound-guided radial arterial catheterization.
abstract: This study assessed the effect of bevel direction on the success rate of ultrasound guided radial artery catheterization.
  
  
  
  A total of 204 patients requiring radial artery catheterization were randomly divided into bevel-up (n = 102) and bevel-down (n = 102) groups. Success rate, cannulation time, and number of attempts were compared groups.
  
  
  
  In the bevel-down group, an arterial line was placed on the first attempt in 86 of 102 (84.3 %; 95 % confidence interval [CI] = 76 % to 90 %) patients versus 73 of 102 (71.6 %; 95 % CI = 62.1 % to 79.4 %) in the bevel-up group (p = 0.028). In the bevel-down group, the mean time to a successful radial arterial cannulation was 33.3 ± 6.3 seconds (95 % CI = 32.1-34.6) versus 35.9 ± 7.6 seconds (95 % CI = 34.4-37.2) in the bevel-up group (p = 0.011). The median score was 33.2 and interquartile range [IQR] was 10.9 (30.3-41.2) for the mean cannulation time in the bevel-up group. In the bevel-down group, the mean score was 32.3 (IQR 3.90, 30-33.9) for mean cannulation time. In the bevel-down group, 11 of 102 (7 %; 95 % CI = 0 to 16 %) patients developed a posterior wall puncture versus 22 of 102 ((21.6 %; 95 % CI = 14.7 to 17.2 %) in the bevel-up group.
  
  
  
  The bevel-down approach during ultrasound-guided radial artery catheterization exhibited a higher success with fewer complications compared to the bevel-up approach.
  
  
  
  Clinical Research Information Service is Korean Clinical Trials Registry ( KCT0001836 ). It was registered retrospectively 30th Nov 2015.
authors.affiliation: Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Min
authors.affiliation: Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, South Korea.
authors.forename: Hyong-Rae
authors.initials: HR
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Inha University Hospital, Sinheung-dong 3-ga, Jung-gu, Incheon, 400-711, South Korea.
authors.forename: Chun Woo
authors.initials: CW
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Inha University Hospital, Sinheung-dong 3-ga, Jung-gu, Incheon, 400-711, South Korea.
authors.forename: Woo Hee
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Inha University Hospital, Sinheung-dong 3-ga, Jung-gu, Incheon, 400-711, South Korea. wangunlove@gmail.com.
authors.forename: Byung-Gun
authors.initials: BG
authors.lastname: Kim
mesh_terms: D000368:Aged; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging*; D016037:Single-Blind Method; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*