Right heart catheterization and other venous cardiovascular procedures from the arm

Right heart catheterization using peripheral venous access is an approach initially used by pioneers of cardiovascular exploration, but subsequently almost forgotten with the popularization of direct puncture techniques of central veins for diagnostic, monitoring and therapeutic needs. Improved equipment and the recognition of the complications of direct central (femoral) artery puncture resulted in the development of transradial techniques and, subsequently, invasive peripheral venous techniques for right heart catheterization. Case series and comparisons have been published on these newer peripheral venous techniques and the results have been very favorable in support of these newer approaches, although randomized data are not available. Further refinements in equipment and techniques offer the potential for further growth in invasive peripheral venous access.