Needle vs cannula over needle for transradial catheterization was studied in 500 patients randomized between the two methods. The primary endpoint was a combined failure of radial artery cannulation or needing to switch access sites. Secondary endpoints included individual failure rates, procedure times, and safety outcomes. Results found the primary endpoint occurred in 6.4% of patients, with no significant differences in failure rates, times, or safety between needle and cannula methods. The conclusion was that both methods seem equal in efficacy and safety, and cardiologists should use the method they feel most comfortable with.

1. Needle vs cannula over needle
for transradial catheterization
Michael Koutouzis
Red Cross General Hospital
Athens, Greece

2. Conflict of interest
None

4. Study plan
-500 patients scheduled to undergo transradial catheterization
were randomized between needle and cannula over needle puncture
-21G needle and 20G cannula with wings were used respectively,
5F introducer was used (KDL China)
-If ad hoc angioplasty was decided, change to a 6F or 7F introducer was
performed over a 0.038’’ guidewire
-All comers study, 5 different Greek centers (11 operators) specialized
in radial approach

6. Primary Endpoint
• The combined endpoint of switching
cannulation method or switching access site,
due to failure of radial artery cannulation.
* If an access site switch was performed, despite successful
sheath insertion, due to radial artery spasm, tortuosity or
other reasons, this was recorded, but not considered as an
endpoint.

7. Secondary endpoints
• switch of cannulation method
• switch of access site, due to cannulation failure
• time for cannulation
• total procedure time
• number of attempts for successful cannulation
• number of skin punctures
(this is different from attempts, since several attempts
can be performed through a single skin puncture).

8. Safety endpoints
• the incidence of hematomas EASY class III or
more
• the incidence of RAO at discharge,
documented with ultrasonography.

9. Demographic characteristics

10. Procedural characteristics

11. Procedural characteristics
93% right radial approach

12. Procedural characteristics
93% right radial approach 32% Ad hoc PCI

13. Primary endpoint

14. Primary and secondary endpoints

15. Access site switch
32 patients (6.4%)
15 patients due to failed radial artery
cannulation
17 due to failure to complete the procedure,
after successful sheath insertion
(8 due to tortuosity, 6 due to spasm and 3 due
to radial dissection/perforation)

16. Alternative access site
Femoral artery: 16 patients (50%)
Contralateral radial artery: 10 patients (32%)
Ipsilateral ulnar: 5 patients (15%)
Contralateral ulnar: 1 patient (3%)

17. Conclusion
Radial artery canullation with needle and with
cannula over needle seem to be equal in terms of
efficacy and safety
The interventional cardiologists should use the
method they feel more comfortable with

18. Thank you