Feasibility and safety of right heart catheterization via median cubital vein in patients with pulmonary hypertension

To assess the feasibility and safety of right heart catheterization (RHC) via the cubital vein. This retrospective-prospective cohort study included 93 patients (January 2020–June 2023) in the retrospective phase, with 48 undergoing cubital vein RHC (R-CV) and 45 femoral vein RHC (R-FV). A prospective phase (July 2023–October 2024) enrolled 60 patients, each undergoing both approaches. Subgroup analysis divided patients by right ventricular end-diastolic diameter (≥ 3.80 cm vs. <3.80 cm). R-CV showed fewer complications (8.89% vs. 0%, p = 0.028) and shorter fluoroscopy time (178.27 ± 43.27 s vs. 210.76 ± 54.80 s, p = 0.002) than R-FV. In patients with right ventricular dilation (≥ 3.80 cm), cubital vein RHC reduced fluoroscopy time compared to femoral vein RHC (p < 0.001). Cubital vein RHC is safe, efficient, and especially advantageous for patients with enlarged right ventricles, warranting wider adoption.