Ultrasound-guided dynamic needle tip positioning versus conventional palpation for improving the success rate of radial artery catheterization: A randomized controlled trial.

IF 1.7 3区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of Vascular Access Pub Date : 2026-05-07 DOI:10.1177/11297298261444407

Baoying Feng, Xiayu Zou, Jieqiang Du, Ruiming Luo, Zhixin Wu, Yuyuan You

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引用次数: 0

Abstract

Background: Ultrasound guidance enhances arterial catheterization by enabling real-time visualization. Various ultrasound-assisted techniques have been described. This study evaluated the clinical utility of ultrasound-guided dynamic needle tip positioning (DNTP) for radial artery catheterization compared with traditional palpation.

Methods: Our study included 160 patients scheduled for elective surgery at Foshan Hospital of Traditional Chinese Medicine from February 2024 to March 2025. They were randomly assigned to either the traditional palpation group (n = 80) or the DNTP group (n = 80) via a web-based randomization tool. In accordance with the intention-to-treat (ITT) principle, all 160 randomized patients were included in the primary analysis. Outcomes included first-attempt success, overall success, procedure time, catheter use, and complications. Subgroup analyses were based on arterial depth and cross-sectional area.

Results: The DNTP group achieved significantly higher first-attempt and overall success rates than the palpation group (80/80, 100.00% vs 65/80, 81.25% and 80/80, 100.00% vs 66/80, 82.50%; all p < 0.001). Median procedure time was shorter with DNTP (27.5 s (12-98)) compared with palpation (35 s (20-173); p = 0.039). Successful cannulation within 3 min using a single attempt occurred in 100.00% (80/80) of DNTP cases versus 81.25% (65/80) in the palpation group (p < 0.001). Single-catheter use was more frequent in the DNTP group (80/80, 100.00%) than in the palpation group (73/80, 91.25%; p = 0.007). Complication rates were significantly lower with DNTP (13/80, 16.25%) compared with palpation (40/80, 50.00%; p < 0.001). Stratified analyses showed greater benefits of DNTP in patients with deeper arteries (>2 mm) and smaller cross-sectional areas (⩽3 mm²), with significant treatment-subgroup interactions for arterial depth (p = 0.021) and cross-sectional area (p = 0.008).

Conclusions: Ultrasound-guided DNTP significantly improves the success rate, efficiency, and safety of radial artery catheterization, particularly in patients with unfavorable arterial anatomy.

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超声引导下动态针尖定位与常规触诊提高桡动脉插管成功率：一项随机对照试验。

背景：超声引导通过实现实时可视化来增强动脉导管。各种超声辅助技术已被描述。本研究评估超声引导下动态针尖定位（DNTP）在桡动脉置管中的临床应用，并与传统触诊进行比较。方法：研究对象为2024年2月至2025年3月在佛山市中医院择期手术的160例患者。通过基于网络的随机化工具，他们被随机分配到传统触诊组（n = 80）或DNTP组（n = 80）。根据意向治疗（ITT）原则，所有160例随机患者均纳入初步分析。结果包括首次尝试成功、总体成功、手术时间、导管使用和并发症。亚组分析基于动脉深度和横截面积。结果：DNTP组首次尝试成功率和总成功率均显著高于触诊组（80/ 80,100.00% vs 65/ 80,81.25%; 80/ 80,100.00% vs 66/ 80,82.50%; p = 0.039）。100.00%（80/80）的DNTP病例在3分钟内成功插管，而触诊组为81.25% (65/80)（p p = 0.007）。DNTP的并发症发生率（13/ 80,16.25%）明显低于触诊（40/ 80,50.00%;p 2 mm）和更小的横截面积（≤3 mm2），在动脉深度（p = 0.021）和横截面积（p = 0.008）方面治疗-亚组间的相互作用显著。结论：超声引导下的DNTP可显著提高桡动脉置管的成功率、效率和安全性，特别是对于动脉解剖不良的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Access 医学-外周血管病

CiteScore

3.40

自引率

31.60%

发文量

181

审稿时长

6-12 weeks

期刊介绍： The Journal of Vascular Access (JVA) is issued six times per year; it considers the publication of original manuscripts dealing with clinical and laboratory investigations in the fast growing field of vascular access. In addition reviews, case reports and clinical trials are welcome, as well as papers dedicated to more practical aspects covering new devices and techniques. All contributions, coming from all over the world, undergo the peer-review process. The Journal of Vascular Access is divided into independent sections, each led by Editors of the highest scientific level: • Dialysis • Oncology • Interventional radiology • Nutrition • Nursing • Intensive care Correspondence related to published papers is also welcome.