Radial artery catheterization techniques

Separate-guidewire approach*: The nondominant hand palpates the artery while the dominant hand manipulates the catheter, which is inserted and advanced slowly until pulsatile blood return is observed. The catheter is advanced slightly, ensuring the outer catheter has also entered the lumen. Care must be taken to avoid puncturing the posterior wall of the vessel when advancing the catheter. The nondominant hand then stabilizes the catheter while the dominant hand removes the needle from the intravascular catheter. If pulsatile blood return is observed after the needle is removed, the guidewire is advanced until its tip is beyond the distal end of the catheter. Finally, the catheter is advanced into the artery over the guidewire and the guidewire is removed.
Integral-guidewire approach*: The guidewire of this specialized device is integrated with the needle and catheter. The nondominant hand palpates the artery, while the dominant hand manipulates the needle-guidewire-catheter unit, which is inserted and advanced slowly until pulsatile blood return is observed. The nondominant hand then stabilizes the needle-guidewire-catheter unit, while the dominant hand advances the guidewire tab to push the wire into and through the needle and catheter. The outer catheter is advanced over the needle and wire into the artery. Finally, the needle-guidewire unit is removed.