Direct vs. Seldinger Technique for Ultrasound-Guided Difficult Radial Access in Cardiac Surgery

NCT07400627 | Not Yet Recruiting

• 1 other identifier: AEŞH-EK-2025-221
• Study Type: interventional
• Target: 242
• Locations: 1 country
• Sites: 1

Brief Summary

Radial artery cannulation is a routine procedure for invasive hemodynamic monitoring for patients undergoing cardiovascular surgery patients. Although ultrasound (USG) guidance is known to improve success rates, there is limited data comparing the efficacy of the 'Direct' versus 'Seldinger' techniques specifically in patients with anticipated difficult radial access. This study aims to compare the effectiveness of USG-guided Direct cannulation and USG-guided Seldinger techniques in adult patients with anticipated difficult radial arterial cannulation.

Conditions

Cardiac Surgery in Adult Patient; Cardiac Surgery; Radial Artery Cannulation; Arterial Cannulation; Radial Artery Catheterization

Keywords

difficult radial artery cannulation; direct technique for radial artery cannulation; Seldinger technique for radial artery cannulation

Outcome Measures

Primary Outcomes (1)

• First-Attempt Cannulation Success Rate

  The proportion of patients in whom radial artery cannulation is successfully performed (verified by the appearance of the arterial pressure waveform on the monitor) with a single skin puncture

  10 min before anesthesia induction

Secondary Outcomes (3)

• Number of Cannulation Attempts

  10 min before anesthesia induction

• Radial artery cannulation time

  10 min before anesthesia induction

• Incidence of Procedure-Related Complications

  Postoperative 24th hour

Study Arms (2)

Ultrasound-Guided Direct Cannulation Technique

EXPERIMENTAL

Patients in this group will undergo radial artery cannulation using the ultrasound-guided direct technique.

Procedure: Ultrasound-Guided Direct Cannulation Technique

Ultrasound-Guided Seldinger Cannulation Technique

ACTIVE COMPARATOR

Patients in this group will undergo radial artery cannulation using the ultrasound-guided Seldinger technique.

Procedure: Ultrasound-Guided Seldinger Cannulation Technique

Interventions

Ultrasound-Guided Direct Cannulation Technique PROCEDURE

Radial artery cannulation performed using the direct puncture technique (catheter-over-needle) under real-time ultrasound guidance.

Ultrasound-Guided Direct Cannulation Technique

Ultrasound-Guided Seldinger Cannulation Technique PROCEDURE

Radial artery cannulation performed using the Seldinger technique (catheter-over-guide-wire) under real-time ultrasound guidance.

Ultrasound-Guided Seldinger Cannulation Technique

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged 18 years or older
• American Society of Anesthesiologists (ASA) physical status I-IV
• Patients scheduled for cardiovascular surgery requiring invasive arterial monitoring

You may not qualify if:

• Patients undergoing emergency surgery
• Coagulation disorders or known coagulopathy
• Presence of an arteriovenous fistula
• Patients in shock or hemodynamically instable
• Patients requiring mechanical circulatory support
• History of Raynaud's phenomenon
• Refusal to participate in the study

Sponsors & Collaborators

• Diskapi Teaching and Research Hospital: lead

Study Sites (1)

Ankara Etlik City Hospital

Ankara, 06170, Turkey (Türkiye)

Location

Related Publications (4)

• Abdel-Kader, A. , Kaushal, N. , Shah, R. , Gomulka, M. , Wang, T. and Shulman, S. (2016) A Novel Technique to Maintain Radial Arterial Catheter Position: The Arterial Catheter Stabilizer. Open Journal of Anesthesiology, 6, 193-197. doi: 10.4236/ojanes.2016.612029.

  BACKGROUND

• Sung JM, Jun YE, Jung YD, Kim KN. Comparison of an Ultrasound-Guided Dynamic Needle Tip Positioning Technique and a Long-Axis In-Plane Technique for Radial Artery Cannulation in Older Patients: A Prospective, Randomized, Controlled Study. J Cardiothorac Vasc Anesth. 2023 Dec;37(12):2475-2481. doi: 10.1053/j.jvca.2023.08.138. Epub 2023 Aug 25.

  PMID: 37741770 BACKGROUND

• Mesa BK, Sinha M, Kumar M, Ramchandani S, Dey C, Agrawal N, Khetarpal M. Radial Arterial Cannulation by Ultrasound-Guided Dynamic Needle-Tip Positioning Using the Short-Axis Out-of-Plane Approach Versus the Long-Axis In-Plane Approach: A Randomized Controlled Study. Cureus. 2024 Feb 14;16(2):e54183. doi: 10.7759/cureus.54183. eCollection 2024 Feb.

  PMID: 38496072 BACKGROUND

• Nam K, Jeon Y, Yoon S, Kwon SM, Kang P, Cho YJ, Kim TK. Ultrasound-guided radial artery cannulation using dynamic needle tip positioning versus conventional long-axis in-plane techniques in cardiac surgery patients: a randomized, controlled trial. Minerva Anestesiol. 2020 Jan;86(1):30-37. doi: 10.23736/S0375-9393.19.13646-2. Epub 2019 Jun 17.

  PMID: 31213045 BACKGROUND

Study Officials

• Dilek ÜNAL

  Saglik Bilimleri Universitesi

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Dilek ÜNAL, Professor

CONTACT

+905336957855; dilekunalmd@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Anesthesiology

Model Details: Prospective randomised

Study Record Dates

• First Submitted: February 3, 2026
• First Posted: February 10, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: February 10, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)