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

Abstract

Objective: To assess the feasibility and safety of right heart catheterization (RHC) via the cubital vein. Methods: 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). Results: 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). Conclusion: Cubital vein RHC is safe, efficient, and especially advantageous for patients with enlarged right ventricles, warranting wider adoption.