Wrist Extension Does Not Change the Position of the Radial Artery: Cadaveric Study With Application to Arterial Line Placement, and Transradial Neurointerventional Procedures

Couldwell M, Elzamly K, Hextrum S, Aysenne A, Olewink L, Iwanaga J, Nerva J, Dumont AS, Tubbs RS

BACKGROUND: The radial artery is gaining popularity as a vascular access site for neurointerventional procedres. However, recent analyses of wrist position and radial artery anatomy has suggested that the extended position of the wrist is not always necessary. Therefore, the following cadaveric study was performed to verify these findings.METHODS: Twenty adult cadaveric upper limbs under-went dissection of the radial artery. The radial artery was exposed but left in its anatomical position. With the hand supinated, the wrist was extended to 45 degrees and 90 degrees. Observations were then made of any movement of the artery during these ranges of motion. Next, a tension gauge was attached to the radial artery and any tension on the artery measured during the above noted ranges of motion.RESULTS: During extension of the wrist, none of the radial artery specimens was found to move in any direction. Moreover, an average of only 0.28 N of tension on the artery was found with wrist extension up to 90 degrees. Our cadaveric study found that, contrary to popular belief, extension of the wrist during cannulation of the radial artery does not change the position of the artery nor does it significantly alter the tension on the artery.CONCLUSIONS: These data support several recent clinical studies.

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