Comparison of Combined Long- and Short-Axis Laser-Assisted Ultrasound-Guided Radial Artery Cannulation With Long-Axis Ultrasound Guidance in Adults: A Randomized Clinical Trial

doi:10.1053/j.jvca.2026.07.026

Haemodynamics, fluids & transfusion

Comparison of Combined Long- and Short-Axis Laser-Assisted Ultrasound-Guided Radial Artery Cannulation With Long-Axis Ultrasound Guidance in Adults: A Randomized Clinical Trial

J Cardiothorac Vasc AnesthPublished 16 Jul 2026Randomised controlled trial

Primary result · First-attempt success rateResultAbsolute difference 20 % 95% CI 10.0%–28.3%

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Authors' conclusion

Compared with long-axis in-plane ultrasound guidance, long- and short-axis laser-assisted ultrasound guidance for radial artery cannulation significantly improved the first-attempt and total success rates while reducing positioning time and complications.

Study context

Population: Adults scheduled for GA requiring radial artery cannulation, tertiary academic cardiac hospital
Participants: 260 adults

Comparison: Long- and short-axis laser-assisted vs Long-axis in-plane
Long- and short-axis laser-assistedn = 130
Long-axis in-planen = 130reference
Primary endpoint: First-attempt success rate

Methodological detailssingle-centre, prospective, parallel-group, Two experienced operators performed cannulation under local anesthesia in the preanesthesia room

Single-centre
Prospective
Parallel-group
Two experienced operators performed cannulation under local anesthesia in the preanesthesia room

Primary result

As reported in the abstract

Absolute difference

20 %

95% CI 10.0%–28.3%

P < 0.001

Events by treatment group

Long- and short-axis laser-assisted92%119 of 130

Long-axis in-plane72%94 of 130

Long- and short-axis laser-assisted vs Long-axis in-plane

absolute difference 20 % (95% CI 10.0%–28.3%); P < 0.001

Secondary outcomes

Outcome	Long- and short-axis laser-assisted	Long-axis in-plane	← Lower with Long- and short-axis laser-assisted ←→ Higher with Long- and short-axis laser-assisted →	Absolute difference (%) (95% CI)	P value
Overall success rate	98%	88%	−1001020	10 (4.8%–17.6%)	P = 0.001
			−1001020Difference, % (linear scale)

Time to success on first attempt · no significant difference

P = 0.09

Long- and short-axis laser-assistedmedian 29 secondsIQR 24–35

Long-axis in-planemedian 32 secondsIQR 24–38

Time to success within 2 attempts

P = 0.005

Long- and short-axis laser-assistedmedian 30 secondsIQR 25–36

Long-axis in-planemedian 36 secondsIQR 26–41

Total procedural time

P < 0.001

Long- and short-axis laser-assistedmedian 30 secondsIQR 25–36

Long-axis in-planemedian 37 secondsIQR 27–67

US localization time

P < 0.001

Long- and short-axis laser-assistedmedian 9 secondsIQR 7–11

Long-axis in-planemedian 18 secondsIQR 14–21

Use of penetration method

P < 0.001

Long- and short-axis laser-assisted6%

Long-axis in-plane25%

Outcome	Long- and short-axis laser-assisted	Long-axis in-plane	P value
Needle-tip adjustmentsMedian	0 (IQR 0–1)	2 (IQR 1–3)	P < 0.001
Number of attemptsMedian	1 (IQR 1–1)	1 (IQR 1–2)	P < 0.001
Puncture-site change	8%	19%	P = 0.006

Safety

Hematoma

P < 0.001

Long- and short-axis laser-assisted4%

Long-axis in-plane22%

Vasospasm

P = 0.013

Long- and short-axis laser-assisted7%

Long-axis in-plane17%

Events

Outcome	Long- and short-axis laser-assisted	Long-axis in-plane
Distal ischemia of punctured artery	0	0

Original publication

Comparison of Combined Long- and Short-Axis Laser-Assisted Ultrasound-Guided Radial Artery Cannulation With Long-Axis Ultrasound Guidance in Adults: A Randomized Clinical Trial. J Cardiothorac Vasc Anesth. Published 16 July 2026. doi:10.1053/j.jvca.2026.07.026

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