时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
The clinical value of distal access, therefore, depends on whether its potential gains in catheter stability and access-site safety offset any loss of procedural efficiency.Comparative evidence remains inconsistent.；We hypothesize that ultrasound-guided distal radial artery catheterization is noninferior to conventional radial artery catheterization for first-attempt success.；Access to identifiable source documents will be limited to authorized investigators, monitors, the ethics committee, and regulatory authorities as permitted by law.Dissemination and data sharingResults will be submitted to a peer-reviewed journal and presented at relevant scientific meetings regardless of whether the primary hypothesis is supported.
方法
Although ultrasound guidance improves first-attempt success and reduces attempts and hematomas in older patients (6, 7), it does not resolve which radial access site is preferable.The distal radial artery in the anatomical snuffbox or dorsoradial hand has been proposed as an alternative to the conventional wrist site.；A 2026 meta-analysis of 12 randomized trials involving 1,790 participants found no overall difference in first-attempt success and suggested fewer hematomas, bleeding events, catheter blockages, and unstable waveforms with distal access, although insertion took longer (13).；Importantly, the age-stratified analysis suggested lower first-attempt success in patients older than 65 years; certainty was low, techniques were heterogeneous, and ultrasound was not consistently used from the initial attempt (13).A trial restricted to older surgical patients and using the same ultrasound-guided technique, catheter, and outcome definitions in both groups is therefore needed to isolate the effect of access site.
核心结论
Before enrolling participants, each operator must demonstrate protocol adherence in simulation and complete at least 20 successful supervised distal and 20 successful conventional ultrasound-guided radial catheterizations, or provide documented equivalent recent experience.
局限
However, the distal artery is generally smaller and may be deeper, potentially reducing first-attempt success and prolonging catheterization.；Maitra et al., however, found lower first-attempt success with distal access (57% vs. 77%) and longer catheterization time (9).；Due to limitations in sample size, this section contains only exploratory results.Patency of the distal and conventional radial arteries on color and pulsed-wave Doppler at 24 h.
对本项目的价值
中等价值：属「血管 / 心血管老化」方向；血管 / 心血管老化栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.6/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 39,430 字符，题名指纹 1.0，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：老年手术患者超声引导桡动脉远端 versus 常规位置穿刺置管：随机对照非劣效试验方案
- 英文标题：Ultrasound-guided distal versus conventional radial artery catheterization in older surgical patients: protocol for a randomized controlled noninferiority trial.
- 期刊与标识：Frontiers in medicine · PMID 42973883 · DOI 10.3389/fmed.2026.1985261 · PMC PMC13724536