How to TRY TRI
TRI Basics Puncture
How to puncture radial artery and place introducer sheath.
Bevel side up
|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|
Insert the needle into the artery; blood flush
Insert the needle into and over the artery; no flush
Remove inner needle
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.
- Pancholy SB et al., Catheter Cardiovasc Interv. 2012;80(2):288-291.
- Seto AH et al. JACC Cardiovasc Interv. 2015 Feb; 8 (2): 283-291.