Korean Circ J.  2016 Mar;46(2):207-212. 10.4070/kcj.2016.46.2.207.

Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

• Lee SH
• Chun KJ
• Lee DS
• Lee SY
• Hwang J
• Chon MK
• Hwang KW
• Kim JS
• Park YH
• Kim JH

• KMID: 2344472
• DOI: http://doi.org/10.4070/kcj.2016.46.2.207

Abstract

BACKGROUND AND OBJECTIVES
Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients.
SUBJECTS AND METHODS
The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications).
RESULTS
We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group.
CONCLUSION
Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients.

Keyword

Cardiac catheterization; Cephalic vein; Basilic vein

MeSH Terms

Bed Rest
Cardiac Catheterization*
Cardiac Catheters*
Femoral Vein
Forearm
Hematoma
Hemorrhage
Humans
Medical Records
Retrospective Studies
Veins*
Walking

Figure

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  Fig. 1 Process of right cardiac catheterization via the antecubital fossa vein. (A) Finding a palpable or visible antecubital fossa vein by using a tourniquet. (B) A cephalic vein punctured with a 20-gauge Instyle intravenous cannula. (C) Local anesthesia achieved via 2% lidocaine infiltration around the puncture site. (D and E) Insertion of the sheath guide wire via the intravenous cannula. (F) Incision using a surgical blade at the puncture site. (G and H) A 6-French vein sheath inserted in the antecubital fossa vein. (I) Radiograph of the right arm at the elbow after insertion of a 6-French vein sheath in the antecubital fossa vein. (J and K) Radiograph of a 6-French, balloon-tipped, 2-lumen catheter in the superior vena cava, right ventricle, and pulmonary artery.

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