Long-term Effects of Radial Artery Cannulation on Vessel Diameter, Blood Flow and Fine Motor Skills

This observational study examined changes in blood vessel diameter, blood flow, and fine motor performance after ultrasound-guided radial artery cannulation in adults undergoing elective cardiac surgery. Ultrasound measurements of the radial and ulnar arteries and Purdue Pegboard tests of hand performance were obtained before cannulation and during follow-up for three months. Measurements were compared over time within each participant and between the relevant arteries or hands.

Study Overview

• Status: Completed
• Conditions: Fine Motor Skills; Ultrasound; Radial Artery
• Intervention / Treatment: Procedure: radial artery catheterization

Detailed Description

This single-centre prospective longitudinal observational study was conducted in the Department of Cardiovascular Surgery at Pamukkale University Faculty of Medicine. Adults aged 18-80 years with American Society of Anesthesiologists physical status I-III who required radial arterial monitoring during elective cardiac surgery were recruited consecutively from 22 July to 2 September 2016. Baseline assessments were performed in all 103 enrolled participants. Radial and ulnar artery internal diameter, peak systolic velocity, end-diastolic velocity, resistive index, pulsatility index, and mean volume flow were assessed before cannulation and at seven subsequent time points over three months. Purdue Pegboard performance was assessed before cannulation, 10 days after baseline, and three months after baseline. Comparisons were made within participants over time, between the radial and ulnar arteries of the cannulated arm, and between the cannulated left and non-cannulated right hands; bimanual performance was assessed separately. Fifty participants completed all reported assessments and were included in the complete-case analysis. The other 53 participants did not complete follow-up because of death (7), severe postoperative morbidity (13), incomplete follow-up attendance (22), or technical or organizational reasons (11). Individual-level partial records for these 53 participants were unavailable for reanalysis. The study received ethics committee approval on 19 July 2016, and written informed consent was obtained before study procedures. The investigation originated as a medical specialty thesis completed in 2017 and was retrospectively registered in 2025.

• Study Type: Observational
• Enrollment (Actual): 103

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adults aged 18-80 years with American Society of Anesthesiologists physical status I-III who were scheduled for elective cardiac surgery and required radial arterial monitoring at Pamukkale University Faculty of Medicine, Department of Cardiovascular Surgery. Eligible patients were recruited consecutively from 22 July to 2 September 2016.

Description

Inclusion Criteria:

• Age 18-80 years.
• American Society of Anesthesiologists physical status I-III.
• Scheduled for elective cardiac surgery, including coronary artery bypass grafting, valve surgery, the Bentall procedure, or atrial septal defect repair.
• Requirement for radial arterial monitoring.

Exclusion Criteria:

• Emergency surgery.
• Haemodynamic instability.
• Planned femoral arterial cannulation.
• Body mass index >35 kg/m².
• Peripheral vascular disease.
• Infection at the puncture site.
• An abnormal pulse-oximetry-assisted modified Allen screening result.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in radial and ulnar artery diameter and Doppler parameters over three months	Internal anteroposterior diameter (mm), peak systolic velocity (cm/s), end-diastolic velocity (cm/s), resistive index (unitless), pulsatility index (unitless), and mean volume flow (mL/min) of the radial and ulnar arteries in the cannulated arm were measured by ultrasound. Each value was the mean of three independent acquisitions. Each parameter was analysed separately for changes from baseline and differences between arteries. T1 was 1 minute after anesthesia induction following cannulation; T2 was 30 minutes after cannulation; T3 was postoperative day 1; T4 was 3 days after cannulation; T5, T6 and T7 were 10 days, 1 month and 3 months after baseline, respectively.	Before cannulation (T0); 1 minute after anesthesia induction (T1); 30 minutes after cannulation (T2); postoperative day 1 (T3); 3 days after cannulation (T4); 10 days (T5), 1 month (T6), and 3 months (T7) after T0.
Changes in Purdue Pegboard fine motor performance over three months	Fine motor performance was assessed using the Purdue Pegboard Test (Model 32020). The right hand, left hand, and both hands together were tested in separate 30-second subtests. Unilateral scores counted successfully inserted pins; bimanual scores counted completed pin pairs, with one pin placed by each hand. Each subtest was repeated three times and the mean score was analysed. Higher scores indicate better performance. The left hand was the cannulated hand and the right hand was the non-cannulated hand. Unilateral performance was compared between hands and over time; bimanual performance was analysed separately over time. The 60-second assembly subtest was not performed.	Before cannulation (T0), 10 days after T0 (T5), and 3 months after T0 (T7).

Collaborators and Investigators

• Sponsor: Kartal City Hospital

Publications and helpful links

General Publications

• Numaguchi A, Adachi YU, Aoki Y, Ishii Y, Suzuki K, Obata Y, Sato S, Nishiwaki K, Matsuda N. Radial artery cannulation decreases the distal arterial blood flow measured by power Doppler ultrasound. J Clin Monit Comput. 2015 Oct;29(5):653-7. doi: 10.1007/s10877-014-9648-5. Epub 2014 Dec 16.
• Desrosiers J, Hebert R, Bravo G, Rochette A. Age-related changes in upper extremity performance of elderly people: a longitudinal study. Exp Gerontol. 1999 Jun;34(3):393-405. doi: 10.1016/s0531-5565(99)00018-2.
• Taneja K, Jain R, Sawhney S, Rajani M. Occlusive arterial disease of the upper extremity: colour Doppler as a screening technique and for assessment of distal circulation. Australas Radiol. 1996 Aug;40(3):226-9. doi: 10.1111/j.1440-1673.1996.tb00391.x.

Study record dates

Study Major Dates

• Study Start (Actual): July 22, 2016
• Primary Completion (Actual): December 2, 2016
• Study Completion (Actual): December 2, 2016

Study Registration Dates

• First Submitted: May 1, 2025
• First Submitted That Met QC Criteria: May 15, 2025
• First Posted (Actual): May 16, 2025

Study Record Updates

• Last Update Posted (Actual): September 16, 2026
• Last Update Submitted That Met QC Criteria: September 13, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Fine motor skills; Catheterization; Regional blood flow
• Other Study ID Numbers: radial artery study

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No