Short-Axis Versus Long-Axis Ultrasound-Guided Radial Artery Cannulation

Comparison of Short-Axis and Long-Axis Approaches for Ultrasound-Guided Radial Artery Cannulation: The Effect of Radial Artery Depth on Technique Selection-A Randomized Controlled Trial

This randomized controlled study aims to compare short-axis/out-of-plane and long-axis/in-plane ultrasound-guided techniques for radial artery cannulation in adult patients undergoing elective surgery. The study will also investigate whether the depth of the radial artery from the skin is associated with cannulation success and may help guide the selection of the ultrasound-guided cannulation technique.

Participants will be randomly assigned to either the short-axis/out-of-plane group or the long-axis/in-plane group. Radial artery depth will be measured using ultrasound before cannulation. The two techniques will be compared in terms of cannulation success, including first-attempt success, number of punctures and needle redirections, time to successful cannulation, failed cannulation, and procedure-related complications.

nclusion Criteria:

Age 18 years or older Patients with an indication for radial artery cannulation for invasive arterial monitoring Undergoing a surgical or interventional procedure Radial artery suitable for visualization by ultrasound Provision of written informed consent

Exclusion Criteria:

Age younger than 18 years Infection, burn, scar, or skin lesion at the planned cannulation site Previous vascular surgery involving the study extremity Advanced peripheral arterial disease or radial artery occlusion Inadequate collateral circulation as assessed by the Allen test or ultrasound Severe coagulopathy Presence of an arteriovenous fistula in the study extremity Severe hemodynamic instability Multiple previous failed radial artery cannulation attempts in the same extremity Pregnancy Allergy to ultrasound gel Refusal to participate in the study