Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials
Abstract
1. Introduction
2. Methods
2.1. Research Strategy and Study Design
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Conflicts of Interest
Abbreviations
PCvI | percutaneous cardiovascular interventions |
UGC | ultrasound guided cannulation |
SA | Standard approach |
MB | Major Bleeding |
TFA | Trans-femoral access |
ACUITY | Acute Catheterization and Urgent Intervention Triage strategY |
ACS | acute coronary syndrome |
CFA | common femoral artery |
MACE | major adverse cardiovascular events |
References
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Dudeck et al. 2004 [17] | Seto et al. 2010 [9] | Gedikoglu et al. 2013 [18] | Slattery et al. 2014 [19] | Marquis-Gravel et al. 2018 [10] | Katırcıbaşı et al. 2018 [8] | Nguyen et al. 2019 [7] | |
---|---|---|---|---|---|---|---|
Primary Endpoint | No primary endpoints specified | CFA cannulation success | No primary endpoints specified | No primary endpoints specified | 1-day immediate procedural outcomes and access-site outcomes * | No primary endpoints specified | 30-day ACUITY major bleeding, MACE and vascular complications § |
Sample Size | 112 | 1,004 | 208 | 100 | 129 | 939 | 688 |
Randomization arms | UGC: 56 SA: 56 | UGC: 503 SA: 501 | UGC: 108 SA: 100 | UGC: 53 SA: 47 | UGC: 64 SA: 65 | UGC: 449 SA: 490 | UGC: 331 SA: 357 |
Comparator (SA) | Arterial Palpation | Fluoroscopy guidance | Arterial palpation and Fluoroscopy guidance | Fluoroscopy guidance | Anatomical landmark and fluoroscopy as bail-out | Fluoroscopy guidance | Arterial palpation or Fluoroscopy guidance |
Age (mean, SD) | UGC: 60 (15) SA: 60 (13) | UGC: 63.5 (12.4) SA: 64.2 (11.4) | UGC: 59 (15.2) SA: 59.5 (13.2) | UGC: 68 (49–92) SA: 66 (32–86) ° | UGC: 65 (58–72) SA: 67 (59–72) ** | UGC: 60.3 (11.4) SA: 59.8 (10.6) | UGC: 63.2 (11.1) SA: 63.8 (11.3) |
Female | UGC: 24 (42.9) SA: 18 (32.1) | UGC: 132 (26.2) SA: 135 (26.9) | UGC: 38 (35.2) SA: 34 (34.0) | UGC: 15 (28.3) SA: 16 (34.0) | UGC: 16 (25.0) SA: 18 (27.7) | UGC: 216 (48.1) SA: 233 (47.6) | UGC: 98 (29.6) SA: 103 (28.9) |
Interventional procedures | NA | USG: 155 (30.8) SA: 161 (32.1) | NA | NA | USG: 36 (57.0) SA: 39 (62.0) | USG: 105 (23.5) SA: 90 (18.3) | USG: 89 (26.9) SA: 99(27.7) |
Sheath Sizes Used (French) | 4–5 | 5.6 (0.9) & | 5–7 | NA | 5–6 | 6 | 6–7 |
UGC technique | Short axis | Short axis | NA | NA | Short/Long axis | Short axis | Short/Long axis |
Dudeck et al. 2004 [17] | Seto et al. 2010 [9] | Gedikoglu et al. 2013 [18] | Slattery et al. 2014 [19] | Marquis-Gavel et al. 2018 [10] | Katırcıbaşı et al. 2018 [8] | Nguyen et al. 2019 [7] | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
USG | SA | USG | SA | USG | SA | USG | SA | USG | SA | USG | SA | USG | SA | |
Efficacy endpoints | ||||||||||||||
First-attempt success rate | 30 (53.6) | 23 (41.1) | 415 (82.7) | 232 (46.4) | 101 (93.5) | 78 (78.0) | NA | NA | 40 (62) | 31 (48) | 396 (84) | 346 (70) | 254 (77.2) | 210 (58.8) |
Time-to-access (sec) | 208 (124) | 197 (165) | 185 (175) | 213 (194) | 68.6 (45.1) | 94.3 (66.4) | 466 (295.5) | 581 (462.3) | NA | NA | 33.3 (28.2) | 41.3 (64.7) | 73.1 (86.7) | 96.9 (131.7) |
Number of attempts | 1.93 (1.26) | 2.16 (1.62) | 1.3 (0.90) | 3.0 (3.20) | 1.5 (0.40) | 2.0 (0.80) | NA | NA | 1.33 (0.76) | 1.66 (0.76) | 1.06 (0.26) | 1.32 (0.74) | 1.35 (0.83) | 1.84 (1.37) |
Safety endpoints | ||||||||||||||
Vascular Complications | NA | NA | 7 (1.4) | 17 (3.4) | 0 (0.0) | 4 (4.0) | 2 (3.8) | 3 (6.4) | 1 (2) | 5 (8) | NA | NA | 4 (1.3) | 3 (0.9) |
Hematoma | 5 (8.9) | 5 (8.9) | 3 (0.6) | 11 (2.2) | 0 (0.0) | 4 (4.0) | 2 (3.8) | 0 (0.0) | NA | NA | 6 (1.3) | 25 (5.1) | 2 (0.6) | 6 (1.8) |
Major Bleeding * | 0 (0.0) | 0 (0.0) | 1 (0.2) | 2 (0.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (4.3) | 1 (2) | 4 (7) | NA | NA | 6 (1.9) | 8 (2.3) |
Pseudoaneurysm | 0 (0.0) | 0 (0.0) | 1 (0.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (2.0) | 1 (0.2) | 1 (0.2) | 3 (0.9) | 2 (0.6) |
Retroperitoneal hematoma | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (4.3) | NA | NA | 0 (0.0) | 0 (0.0) | 1 (0.3) | 0 (0.0) |
Venepuncture | 2 (3.6) | 5 (8.9) | 12 (2.4) | 79 (15.8) | NA | NA | NA | NA | 9 (14) | 21 (32) | 8 (1.7) | 26 (5.3) | 19 (5.8) | 45 (12.6) |
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Sorrentino, S.; Nguyen, P.; Salerno, N.; Polimeni, A.; Sabatino, J.; Makris, A.; Hennessy, A.; Giustino, G.; Spaccarotella, C.; Mongiardo, A.; et al. Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials. J. Clin. Med. 2020, 9, 677. https://doi.org/10.3390/jcm9030677
Sorrentino S, Nguyen P, Salerno N, Polimeni A, Sabatino J, Makris A, Hennessy A, Giustino G, Spaccarotella C, Mongiardo A, et al. Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine. 2020; 9(3):677. https://doi.org/10.3390/jcm9030677
Chicago/Turabian StyleSorrentino, Sabato, Phong Nguyen, Nadia Salerno, Alberto Polimeni, Jolanda Sabatino, Angela Makris, Annemarie Hennessy, Gennaro Giustino, Carmen Spaccarotella, Annalisa Mongiardo, and et al. 2020. "Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials" Journal of Clinical Medicine 9, no. 3: 677. https://doi.org/10.3390/jcm9030677
APA StyleSorrentino, S., Nguyen, P., Salerno, N., Polimeni, A., Sabatino, J., Makris, A., Hennessy, A., Giustino, G., Spaccarotella, C., Mongiardo, A., De Rosa, S., Juergens, C., & Indolfi, C. (2020). Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine, 9(3), 677. https://doi.org/10.3390/jcm9030677