Comparison of ultrasound-guided direct versus ultrasound-guided dart technique of radial artery cannulation: A randomized control study

Background: Three different types of cannulation method for radial artery are Direct technique, Seldinger technique, and modified Seldinger technique (Dart). Their comparative efficacy has been studied using palpatory method but not with ultrasound guidance. Aims: We compared the efficacy of ultrasound-guided Direct and ultrasound-guided Dart technique of arterial cannulation. Settings and Design: One hundred and sixty patients posted for elective surgeries were included in prospective randomized control, single-blind study in a tertiary care center. Materials and Methods: The study comprised of two groups: Direct method (n = 80) and Dart method (n = 80), which were compared for the rate of successful cannulation within 5 min. The secondary objectives were time for successful cannulation, number of attempts, and rate of complications (hematoma, posterior wall puncture, and needle reinsertion) between two groups. Statistical Analysis: The group comparison for continuously distributed data was compared using the independent sample t-test. The Chi-square test was used for the group comparison of categorical data. Binary logistic regression was conducted to ascertain significant predictors for successful cannulation in 5 min. Results: Cannulation success rate was similar in both Direct (57.5%) and Dart (55%) groups. There was no significant difference in time for successful cannulation, number of attempts, number of needle redirection, and posterior wall puncture. However, the incidence of hematoma (Direct 22.5% [18]; Dart 8% [10]) was significant. There was better success rate of cannulation (n = 90) in patients with normal pulse and bigger radial artery lumen. Conclusion: There was no significant difference between Dart and Direct technique with the use of ultrasound guidance.