Ultrasonography fails to reduce bleeding or vascular complications for femoral access: JAMA

Results:

• A total of 621 patients were randomized at 2 centers in Canada
• The primary outcome occurred in 40 of 311 patients (12.9%) in the ultrasonography group vs 50 of 310 patients (16.1%) without ultrasonography
• The rates of Bleeding Academic Research Consortium 2, 3, or 5 bleeding were 10.0% vs 10.7%
• The rates of major vascular complications were 6.4% vs 9.4%
• Ultrasonography improved first-pass success and reduced the number of arterial puncture attempts and venipuncture with similar times to access
• All prerandomization prespecified subgroups were consistent with the overall finding.

Thus, in this randomized clinical trial, use of ultrasonography for femoral access did not reduce bleeding or vascular complications. However, ultrasonography did reduce the risk of venipuncture and number of attempts. Larger trials may be required to demonstrate additional potential benefits of ultrasonography-guided access.

Reference:

Jolly SS, AlRashidi S, d'Entremont M, et al. Routine Ultrasonography Guidance for Femoral Vascular Access for Cardiac Procedures: The UNIVERSAL Randomized Clinical Trial. JAMA Cardiol. Published online September 18, 2022. doi:10.1001/jamacardio.2022.3399

Keywords:

Jolly SS, AlRashidi S, d'Entremont M, Routine, Ultrasonography, Guidance, Femoral, Vascular, Access, Cardiac, Procedures, JAMA Cardiology