Author + information
- Felipe Homem Valle1,
- Rodrigo Wainstein2,
- Bruno Matte3,
- Sandro Cadaval Gonçalves3,
- Ana Maria Krepsky3,
- Luiz Carlos Bergoli4,
- Guilherme Pinheiro Machado5,
- Gustavo Neves de Araújo3 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
- 3Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- 4Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- 5Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
Data regarding safety and feasibility of right heart catheterizations (RHC) through antecubital vein approach is heterogeneous and scarce. Moreover, forearm venous access acquisition under ultrasound guidance has not been specifically evaluated in this scenario.
In order to evaluate success rate and radiation exposure of RHC through antecubital vein approach, data from consecutive RHC performed at our center between January 2014 and March 2017 were collected. Demographic data and procedural outcomes were compared between patient groups defined by venous access site.
In the period, 310 RHC were performed (antecubital vein approach, n=127; femoral vein approach, n=152; jugular vein approach, n=31). There were 129 combined right and left heart catheterizations (LHC): antecubital vein/radial artery approach, n= 57; femoral vein/femoral artery approach, n= 72. Pulmonary hypertension and heart failure were the main indications for both single and combined procedures. Antecubital vein approach success rate was 92.1%. In RHC only procedures (Figure 1A), both antecubital and jugular vein approaches reduced radiation dose, in comparison to femoral vein approach: 43 Gy.cm2 [21.5;113.5], 97 Gy.cm2 [18;165] and 209 Gy.cm2 [129;371], respectively (p<0.001). In combined RHC and LHC (Figure 1B), antecubital vein approach also reduced radiation dose, in comparison to femoral vein approach: 299 Gy.cm2 [158;507] and 516 Gy.cm2 [286;745], respectively (p=0.005).
Our study demonstrated that RHC through antecubital vein approach under ultrasound guided venous puncture is feasible and associated with decreased radiation exposure, in comparison to femoral approach.
OTHER: Vascular Access