Ultrasound-guided femoral and upper extremity venous access for right heart catheterization performed by trained nurses: A comparative observational study

Aim: To compare the safety of common femoral vein (CFV) and upper extremity vein (UEV) access for right heart catheterization (RHC) regarding radiation exposure, fluoroscopy time, and vascular complications. Methods and results: Single-center observational study that included a retrospective CFV group and a prospective UEV group of patients undergoing RHC. Nurses trained in vascular ultrasonography obtained all venous access. Data from 109 patients were analyzed: 55 underwent RHC via CFV and 54 via UEV. Venous access was successfully obtained by nursing staff in 100% (54/54) of UEV cases and 61.1% (33/55) of CFV cases, with no crossover. Mean absorbed radiation dose was significantly lower with UEV compared with CFV [124 µGy·m 2 (46–303) vs 829.5 µGy·m 2 (328–2633); p < 0.001]. No major vascular complications were observed, overall complication rates did not differ significantly ( p = 1.00). Conclusion: UEV access for RHC performed by trained nurses is a safe and feasible alternative with lower radiation exposure.