An interventional study of Dynamic Needle Tip Positioning Technique in Short Axis Approach (DNTP - SA) and Long Axis Approach (LA) in Dynamic Needle Tip Positioning, Short Axis and Arterial Cannulation, sponsored by Tanta University. Completed at 1 site in Egypt. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2025-04-10.
Sponsored by Tanta University · Not applicable, Interventional, and Other
The aim of the present study is to compare between Dynamic Needle Tip Positioning Modification Technique in Short Axis Approach (DNTP - SA) and Long Axis (LA) Approach for Ultrasound-guided Arterial Cannulation as regard time to successful arterial cannula insertion as well as the success rate in the first trial of insertion, number of attempts till successful arterial line placemen, complications, and operators' satisfaction.
Intraoperative Arterial cannulation is recently frequently required especially in high-risk patients or patients with expected major fluid shift.
The most common site for arterial cannulation is the radial artery because of ease of accessibility, dual blood supply to the hand via the ulnar artery, and a low rate of complications. Complications from arterial cannulation include thrombosis, hematoma formation, edema and vasospasm.
Two approaches are basically identified for ultrasound-guided radial artery cannulation, i.e., short-axis out-of-plane (SA-OOP) and long-axis in-plane (LA-IP) techniques.
The dynamic needle tip positioning (DNTP) technique uses the short-axis view of the radial artery with gradual advancing of the needle till reaching the radial artery. Meanwhile, the ultrasound probe is being moved proximally in advance of the needle tip until it disappears from the ultrasound image. The cannula then advanced in the direction of the artery
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Exclusion Criteria:
Ultrasound guided radial artery cannulation by Dynamic Needle Tip Positioning Technique in Short Axis Approach (DNTP - SA) will be performed by an experienced anesthesiologist who has no subsequent role in the study. The ultrasound transducer is oriented transversely to the radial artery at the wrist, and the vessel appears as a circular anechoic structure in the ultrasound screen with gradual advancing of the needle till reaching the radial artery. Meanwhile, the ultrasound probe is being moved proximally in advance of the needle tip until it disappears from the ultrasound image. The cannula then advanced in the direction of the artery.
Other: Dynamic Needle Tip Positioning Technique in Short Axis Approach (DNTP - SA)
Ultrasound guided radial artery cannulation in Long Axis Approach (LA) will be performed by an experienced anesthesiologist who has no subsequent role in the study. In the LA-IP approach, an ultrasound probe is placed parallel to the radial artery and the artery appears as a tubular anechoic structure in ultrasound.
Other: Long Axis Approach (LA)
Ultrasound guided radial artery cannulation by Dynamic Needle Tip Positioning Technique in Short Axis Approach (DNTP - SA) will be performed by an experienced anesthesiologist who has no subsequent role in the study. The ultrasound transducer is oriented transversely to the radial artery at the wrist, and the vessel appears as a circular anechoic structure in the ultrasound screen with gradual advancing of the needle till reaching the radial artery. Meanwhile, the ultrasound probe is being moved proximally in advance of the needle tip until it disappears from the ultrasound image. The cannula then advanced in the direction of the artery.
Ultrasound guided radial artery cannulation in Long Axis Approach (LA) will be performed by an experienced anesthesiologist who has no subsequent role in the study. In the LA-IP approach, an ultrasound probe is placed parallel to the radial artery and the artery appears as a tubular anechoic structure in ultrasound.
Time to achieve successful cannulation
Time to achieve successful cannulation will be measured from initial skin puncture until the catheter is placed into the radial artery.
Time frame: Immediately after catheterization
The success rate
The success rate in the first trial of insertion between the two different approaches will be assessed.
Time frame: Immediately after catheterization
Number of attempts till successful arterial cannula insertion
Number of attempts till successful arterial cannula insertion will be recorded.
Time frame: Immediately after catheterization
Incidence of complications
Complications including edema, hematoma, vasospasm, ischemia, thrombosis and nerve injury will be recorded.
Time frame: 24 hours postoperatively
Operators' satisfaction
Operators' satisfaction (Level of operators' satisfaction will be assessed with a Scale from 1-5)
Time frame: Immediately after catheterization
Plan to share: Yes — The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
Supporting information: Study protocol
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This study is completed, as verified in Apr 2025. You cannot join it, but the record below documents what was studied.
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Tanta University