Complications of Ultrasound-Guided vs. Conventional Radial or Femoral Puncture in the Cardiac Catheterization Laboratory and Electrophysiology Laboratory of a Tertiary Care Hospital Performed by Residents

Introduction: Ultrasound (US) is increasingly used in interventional cardiology and electrophysiology when arterial or venous puncture is required for diagnostic and/or therapeutic purposes. Clinicians must look for ways to reduce procedural risks while maximizing success. Therefore, the US offers significant advantages in guidance during vascular access. Objective: To describe the prevalence of complications from vascular punctures (venous and/or arterial) performed with and without US. Secondly, to compare the complications between the groups. Methods: This was a retrospective and analytic study to determine if the intervention with US guidance reduced complication rates. We evaluated patients who underwent US-guided puncture for diagnostic or therapeutic purposes in June 2024. Results: A total of 54 patients were included, 27 in the US-guided group and 27 in the conventional group. Demographic characteristics, comorbidities, pharmacological treatment, laboratory findings, and indications for puncture were similar between the groups. The number of attempts was similar (p = 0.776), as well as to achieve a successful puncture (p = 0.639). In the US-guided group, ecchymosis was observed in 6 cases (22.2%) vs. 7 cases (25.9%) in the conventional group (p = 0.750). For some outcomes (hematomas’ appearance and hematoma severity), the results favored the use of US-guided punctures to reduce complications. Hematomas occurred in 2 cases (7.4%) in the US group vs. 7 cases (25.9%) in the conventional group (p = 0.068). Hematoma severity, measured using the EASY scale, showed a trend favoring US guidance (p = 0.087). Conclusions: In our study, the use of US-guided interventional and electrophysiological procedures was associated with a trend to reduce hematoma occurrence and its severity with comparable success and attempt rates.