Author + information
- Felipe Homem Valle1,
- Rodrigo Wainstein2,
- Jeruza Neyeloff3,
- Fernando Pivatto Júnior4,
- Gustavo Neves de Araújo4,
- Guilherme Pinheiro Machado3 and
- Marco Wainstein2
- 1Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Norte, Brazil
- 2Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- 3Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- 4Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Right heart catheterization (RHC) is paramount in precise evaluation of several cardiovascular conditions. Although infrequent, complications are almost all related to venous site access. As a parallel to radial approach to left heart catheterization, forearm veins may be a target to reduce accesssite complications during RHC. Our objective was o evaluate the safety and feasibility of RHC through antecubital vein approach, in comparison to femoral and jugular vein approaches.
Systematic review and metaanalysis of published studies. Searches were performed in Medline, EMBASE and Virtual Health Library databases.
11 studies were included in the metaanalysis, all of which compared antecubital versus femoral vein approaches. Antecubital vein approach reduced vascular complications (Figure 1) in 88% (OR 0.12 [95% CI 0.050.33], p<0.001, I2=0%). In regard to success in perform RHC (Figure 2), femoral vein approach outdid antecubital vein approach (OR 9.82[95% CI 2.1744.50], p=0.003, I2=0%). There was no significant difference in radiation exposure outcomes, namely fluoroscopy time and radiation dose. However, high heterogeneity was observed in data analyzed for these outcomes.
In conclusion, although the odds of successful performance of RHC were greater with the femoral vein approach, RHC through antecubital vein approach reduced vascular complications, in comparison to femoral vein approach. In regard to radiation exposure outcomes, there was no statistically significant difference between antecubital and femoral veins approaches.
OTHER: Vascular Access