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Femoral arterial access without routine ultrasound
Routine ultrasound guidance for femoral arterial access
Underpowered for the composite; open-label; operator ultrasound experience varied; the population is the opposite of the ECPR population in the one respect that matters most. [VERIFICATION REQUIRED] — the enrolled sample size is not recorded here because it was not confirmed from a retrieved source.
Adults undergoing coronary angiography or intervention via femoral arterial access, all with a spontaneous circulation
Composite of major bleeding or vascular complication at 30 days
No difference on the primary composite. Every mechanical endpoint favoured ultrasound: higher first-pass success, fewer attempts, fewer inadvertent venipunctures.
Whether that mechanical gain converts into an outcome gain. It does not in an elective catheter laboratory, where a failed pass costs seconds. This chapter argues it does in ECPR, where a failed pass costs minutes of no-flow, but that argument is reasoning, not a finding of this trial. It also does not speak to an arresting patient at all: every participant had a circulation, so pulsatility and blood colour both still identified the vessel.
Ultrasound reliably improves the mechanics of femoral arterial access in a randomised design. The mechanical gain is real and reproducible.