An interventional study of Ultrasound-Guided Direct Cannulation Technique and Ultrasound-Guided Seldinger Cannulation Technique in Cardiac Surgery in Adult Patient, Cardiac Surgery and Radial Artery Cannulation, sponsored by Diskapi Teaching and Research Hospital. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-02-10.
Sponsored by Diskapi Teaching and Research Hospital · Not applicable, Interventional, and Other
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.
Study Protocol and Patient Assessment: Data collection and the procedural intervention will be performed in the preoperative period, prior to the induction of anesthesia. All patients will undergo a modified Allen test. The radial artery site will be selected based on the following hierarchy: preferably the non-dominant hand (unless surgical plan dictates otherwise), an arm with no history of coronary angiography, and the side determined to be easiest for cannulation via ultrasound (USG) assessment.
Ultrasound Assessment and Exclusion: A 12 MHz linear ultrasound probe will be used for all assessments and procedures. Before the intervention, a detailed sonographic evaluation of the radial artery will be recorded, including:
Randomization and Positioning: Patients will be randomized into two groups using a computer-generated random number table:
The patient's arm will be abducted, and the wrist will be extended and fixed over a small support. Standard aseptic preparation and draping will be performed.
Procedural Definitions and Outcome Measures: The procedure will be performed under real-time ultrasound guidance. The following time intervals and metrics will be recorded:
Number of needle maneuvers: The total number of needle advancements towards the artery
Safety and Follow-up: If arterial cannulation fails, manual compression will be applied to the artery for 5 minutes to prevent hematoma formation. All patients will be monitored for complications (such as hematoma, ischemia, or nerve injury) for 24 hours post-procedure.
Diskapi Teaching and Research Hospital is the lead sponsor of 106 studies on the registry; 13 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients in this group will undergo radial artery cannulation using the ultrasound-guided direct technique.
Procedure: Ultrasound-Guided Direct Cannulation Technique
Patients in this group will undergo radial artery cannulation using the ultrasound-guided Seldinger technique.
Procedure: Ultrasound-Guided Seldinger Cannulation Technique
Radial artery cannulation performed using the direct puncture technique (catheter-over-needle) under real-time ultrasound guidance.
Radial artery cannulation performed using the Seldinger technique (catheter-over-guide-wire) under real-time ultrasound guidance.
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
Time frame: 10 min before anesthesia induction
Number of Cannulation Attempts
The total number of skin punctures required to achieve successful radial artery cannulation
Time frame: 10 min before anesthesia induction
Radial artery cannulation time
Total time elapsed from the initial skin contact with the arterial cannula to the visualization of the arterial waveform on the monitor.
Time frame: 10 min before anesthesia induction
Incidence of Procedure-Related Complications
Evaluation of adverse events associated with the cannulation procedure, including hematoma, arterial dissection, posterior wall injury, nerve injury, or infection
Time frame: Postoperative 24th hour
Plan to share: No
Start is estimated for Mar 2026; primary completion for Sep 2026, 6 months later.
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This study is not yet recruiting, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.
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