DIRECT OR MODIFIED SELDINGER GUIDE WIRE-DIRECTED TECHNIQUE FOR ARTERIAL CATHETER INSERTION

Percutaneous radial artery cannulation is widely used for direct conti nuous arterial blood pressure measurement and sampling of arterial blo od. We compared the success rate of arterial catheter placement in pat ients undergoing aortocoronary bypass operations using the direct and the modified Seldinger techniques. The effects of gender and quality o f the pulse were also investigated. Our study group consisted of 42 fe male and 96 male patients. The overall success rate with the guide wir e was 82% compared with that of the direct method of 65% (P = 0.02). T he success rate for arterial cannulation in male patients was high whe ther direct cannulation or a guide wire was used. In female patients, on the other hand, the failure rate with the direct technique was high (57%) and was significantly lower (14%) when the guide wire was used (P < 0.001). We conclude that the success rate for cannulation is high in male patients, and patients with a bounding pulse regardless of th e use of the direct or guide-wire techniques. The guide wire is recomm ended as the initial technique for cannulating the radial artery of fe male patients. In patients with a thready pulse, no significant advant age could be obtained by using a guide wire, but in salvaging an arter ial line the guide wire is efficacious.