Haemodynamics, fluids & transfusion
Safety and efficacy of distal versus conventional radial artery cannulation for invasive blood pressure monitoring: a systematic review and meta-analysis
Authors' conclusion
DRA catheterization for invasive arterial blood pressure monitoring appears to be associated with fewer complications and more stable arterial waveform acquisition than CRA catheterization, despite a longer insertion time.
Study context
- Population
- Patients undergoing radial artery catheterization for invasive arterial BP monitoring (randomized controlled trials (RCTs) up to December 30, 2025)
- Participants
- 1,790 patients · 12 RCTs
- Comparison
- Distal radial artery (DRA) vs conventional radial artery (CRA)
- Outcome
- Haematoma, catheter blockage, bleeding and catheter insertion time
Methodological detailsPRISMA, GRADE evidence quality assessment, subgroup analysis
- PRISMA
- GRADE evidence quality assessment
- Subgroup analysis
Pooled result
As reported in the abstract
DRA vs CRARelative risk (95% CI)
Haematoma
0.42(0.24–0.73)
Catheter blockage
0.33(0.14–0.81)
Bleeding
0.25(0.11–0.59)
DRA vs CRAMD (95% CI)
Catheter insertion time (longer with DRA)
26.89(5.28–48.50)
Further pooled results
Haemostasis time and waveform instability
- DRA associated with shorter haemostasis time and reduced waveform instability
First-attempt success rate and pain scores
- No significant differences in first-attempt success rate or pain scores
First-attempt success rate, patients aged ≤ 65 years (subgroup analysis)
- Higher first-attempt success rate in patients aged ≤ 65 years
- RR = 1.14, 95% CI: 1.02-1.28
- Subgroup analysis
Safety
Complications (haematoma, catheter blockage, bleeding)
- Lower incidences of haematoma, catheter blockage and bleeding with DRA vs CRA (see key findings)
Original publication
Safety and efficacy of distal versus conventional radial artery cannulation for invasive blood pressure monitoring: a systematic review and meta-analysis. J Clin Monit Comput. Published 26 June 2026. doi:10.
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