Gray R J, Rundback J H, Dolmatch B L, Horton K M
Department of Radiology, Washington Hospital Center, Washington, DC 20010, USA.
J Vasc Interv Radiol. 1995 Jan-Feb;6(1):115-8. doi: 10.1016/s1051-0443(95)71073-9.
To evaluate the performance of the ergonomic vascular access needle (EVAN), which is designed to contain blood while allowing for observation of pulsations before passage of a guide wire, in arterial catheterization.
EVANs were used for initial puncture in 118 arterial access procedures. Visualization of pulsatile blood motion and containment of blood were prospectively evaluated. Results from 82 separate procedures performed with standard access needles were used as a control. Success or failure of guide-wire passage through the needle, number of attempts, guide-wire type, findings on the access vessel arteriogram, and complications were recorded for both groups.
In the EVAN group, 92% of procedures were successfully completed, usually within two attempts (82%). Success was independent of guide-wire type (P = .4) and was not significantly different from that of the control group (96%) (P = .37). In 89% of the EVAN procedures, contained pulsatile blood motion was observed before attempted guide-wire passage. Uncontrolled spraying of pulsatile blood did not occur unless the hemostasis valve was removed. In 16%, slow oozing of blood occurred through the needle hub, mainly during guide-wire passage. Oozing was common with floppy-tipped guide wires (46%) but was uncommon with stiffer-tipped wires (6%). There were no needle-related complications.
The EVAN provides protection from blood spray while allowing for successful guide-wire passage into the arterial system as often as standard access needles. However, slow periwire leakage occurs frequently with floppy-tipped guide wires.
