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Brachial Artery Catheterization: An Assessment of Use Patterns and Associated Complications

Handlogten, Kathryn S. BS*; Wilson, Gregory A. RRT, BS†‡; Clifford, Leanne MBBS†‡; Nuttall, Gregory A. MD; Kor, Daryl J. MD†‡

doi: 10.1213/ANE.0000000000000082
Cardiovascular Anesthesiology: Research Report

BACKGROUND: Although studies have compared safety and outcomes of radial artery cannulation with other arterial catheterization locations, there is insufficient information describing brachial artery catheterization. In this study, we characterized the perioperative use patterns and the complication rates associated with brachial arterial catheterization and compared these outcomes with radial artery catheterization.

METHODS: We performed a retrospective analysis of adult patients (age ≥18 years) undergoing surgical procedures at an academic medical center from January 1, 2008, to December 31, 2011. An institutional database containing information on anesthetic care was queried to identify all brachial artery catheterizations. Baseline characteristics, details relating to the surgical and catheterization procedures, and catheter-related complications were collected and compared with a random sample of patients receiving radial artery catheterization.

RESULTS: We identified 858 patients receiving brachial catheterization perioperatively. An additional 3432 patients receiving radial catheterization were identified. Patients receiving brachial catheterization were more often women, had a lower body mass index, had more comorbidities, and had longer anesthetic and catheterization durations. Three vascular complications were identified in the cohort receiving brachial artery catheterization compared with 1 patient with a peripheral neuropathy in the radial artery catheterization cohort (unadjusted complication incidence [95% confidence intervals] brachial artery catheterization, 0.35% [0.12%–1.02%] vs radial artery catheterization, 0.03% [0.005%–0.16%], respectively; P = 0.030; relative risk [95% confidence interval] = 12.0 [1.7–83.4]). There were no catheter-related bloodstream infections.

CONCLUSIONS: We found that brachial artery catheterization is used in more medically complex patients and for longer duration than radial artery catheterizations. Although the limited number of adverse outcomes precluded statistical adjustments in this investigation, the observed differences in complication rates between cannulation methods suggest that brachial artery catheterization may be a suitable alternative to radial artery catheterization in patients with complex medical comorbidities.

From the *Department of Anesthesiology, Mayo Clinic College of Medicine; and Department of Anesthesiology and The Perioperative Outcomes, INformatics, and Transfusion (POINT) Study Team, Mayo Clinic, Rochester, Minnesota.

Accepted for publication October 4, 2013.

Funding: This study was supported, in part, by the Foundation for Anesthesia Education and Research.

Conflict of Interest: See Disclosures at the end of the article.

This report was previously presented, in part, at the American Society of Anesthesiologists Annual Meeting in Washington, DC, October 12–17, 2012.

Reprints will not be available from the authors.

Address correspondence to Daryl J. Kor, MD, Department of Anesthesiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905. Address e-mail to kor.daryl@mayo.edu.

© 2014 International Anesthesia Research Society