RAUST Demonstrates Ultrasound Guidance Helps Facilitate Transradial Access

January 14, 2015—Arnold H. Seto, MD, et al published findings from RAUST (Radial Artery Access With Ultrasound [US] Trial) online ahead of print in the Journal of the American College of Cardiology (JACC): Cardiovascular Interventions. 

The investigators, who sought to assess the utility of US guidance for transradial arterial access, concluded that this practice improves the success and efficiency of radial artery cannulation in patients presenting for transradial catheterization. 

The background of the RAUST study is that US guidance has been demonstrated to facilitate vascular access, but has not been tested in a multicenter randomized fashion for transradial cardiac catheterization.

As summarized in JACC: Cardiovascular Interventions, the RAUST investigators conducted a prospective, multicenter, randomized controlled trial of 698 patients undergoing transradial cardiac catheterization. Patients were randomized to needle insertion with either palpation or real-time US guidance (351 palpation, 347 US). The primary endpoints were the number of forward attempts required for access, first-pass success rate, and time to access.

The investigators found that with US guidance, the number of attempts was reduced, the first-pass success rate improved, and the time to access was reduced. Ten patients in the control group required crossover to US guidance after 5 minutes of failed palpation attempts. Eight of 10 of these patients had successful sheath insertion with US. The number of difficult access procedures was decreased with US guidance. No significant differences were observed in the rate of operator-reported spasm, patient pain scores following the procedure, or bleeding complications, reported the RAUST investigators in JACC: Cardiovascular Interventions.