TRI Puncture
How to TRY TRI
How to Puncture
TRI Basics Puncture
How to puncture radial artery and place introducer sheath.
Needle handling
![Pencil style of needle handling (image)](/sites/g/files/qlpvch321/files/styles/free_crop/public/2022-09/featured_radial_try_tri_puncture_needle_handling_pencil_style_560x344.png?itok=Z1ESAh3I)
Pencil style
![Syringe style of needle handling (image)](/sites/g/files/qlpvch321/files/styles/free_crop/public/2022-09/featured_radial_try_tri_puncture_needle_handling_syringe_style_560x344.png?itok=TaZJ4llw)
Syringe style
![Tip of the needle (image)](/sites/g/files/qlpvch321/files/styles/free_crop/public/2022-09/featured_radial_try_tri_puncture_needle_handling_bevel_side_up_560x344.png?itok=6aXS3INd)
Bevel side up
Two Types of the Puncture with Proper Needle
Anterior puncture | Double wall puncturen | |
---|---|---|
Pros | One action | Easy to target small artery Less bleeding until wire insertion. |
Cons | Shallow angle is critical to avoid possible perforation | Need double action |
Needle |
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Method |
![]() Insert the needle into the artery; blood flush ![]() Insert guidewire |
![]() Insert the needle into and over the artery; no flush ![]() Remove inner needle ![]() Blood flush |
RATE trial *1 showed both are equally safe, and double wall puncture was quicker. Access time (sec.) : 134.2 + 87.5 vs 78.3 + 37.7, p<0.001
Puncture Using Ultrasound
RAUST (Radial Artery Access With Ultrasound Trial) *2 suggest “Seeing is more accurate than feeling”. Ultrasound guidance improves the success and efficiency of radial artery cannulation.
![Ultrasound vs. Palpation (image)](/sites/g/files/qlpvch321/files/2022-09/featured_radial_try_tri_puncture_ultrasound_pc_1844x919.png)