title: Use of a pressure sensing sheath: comparison with standard means of blood pressure monitoring in catheterization procedures.
abstract: OBJECTIVE
  Monitoring of blood pressure (BP) during procedures is variable, depending on multiple factors. Common methods include sphygmomanometer (BP cuff), separate radial artery catheterization, and side port monitoring of an indwelling sheath. Each means of monitoring has disadvantages, including time consumption, added risk, and signal dampening due to multiple factors. We sought an alternative approach to monitoring during procedures in the catheterization laboratory.
  
  
  METHODS
  A new technology involving a 330 µm fiberoptic sensor embedded in the wall of a sheath structure was tested against both radial artery catheter and sphygmomanometer readings obtained simultaneous with readings recorded from the pressure sensing system (PSS). Correlations and Bland-Altman analysis were used to determine whether use of the PSS could substitute for these standard techniques.
  
  
  RESULTS
  The results indicated highly significant correlations in systolic, diastolic, and mean arterial pressures (MAP) when compared against radial artery catheterization (p<0.0001), and MAP means differed by <4%. Bland-Altman analysis of the data suggested that the sheath measurements can replace a separate radial artery catheter. While less striking, significant correlations were seen when PSS readings were compared against BP cuff readings.
  
  
  CONCLUSIONS
  The PSS has competitive functionality to that seen with a dedicated radial artery catheter for BP monitoring and is available immediately on sheath insertion without the added risk of radial catheterization. The sensor is structurally separated from the primary sheath lumen and readings are unaffected by device introduction through the primary lumen. Time delays and potential complications from radial artery catheterization are avoided.
authors.affiliation: Endophys Holdings, LLC, Dallas, Texas, USA.
authors.forename: Phillip D
authors.initials: PD
authors.lastname: Purdy
authors.affiliation: Department of Statistical Science, Southern Methodist University, Dallas, Texas, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: South
authors.affiliation: Department of Interventional Neuroradiology, Methodist Hospital Houston, Houston, Texas, USA.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Klucznik
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Liu
authors.affiliation: Departments of Radiology, Neurology, and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Novakovic
authors.affiliation: Department of Radiology, University of Massachusetts, Worcester, Massachusetts, USA.
authors.forename: Ajit S
authors.initials: AS
authors.lastname: Puri
authors.affiliation: Departments of Radiology and Neurosurgery, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: G Lee
authors.initials: GL
authors.lastname: Pride
authors.affiliation: Departments of Radiology and Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
authors.forename: Beverly
authors.initials: B
authors.lastname: Aagaard-Kienitz
authors.affiliation: Department of Neurological Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors.forename: Abishek
authors.initials: A
authors.lastname: Ray
authors.affiliation: Department of Statistical Science, Southern Methodist University, Dallas, Texas, USA.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Elliott
mesh_terms: D062186:Arterial Pressure / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D005336:Fiber Optic Technology / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D017534:Radial Artery / Q000502:physiology* / Q000601:surgery; D019722:Sphygmomanometers
keywords: Angiography; Blood Pressure; Catheter; Device