Safety and feasibility of transulnar catheterization when ipsilateral radial access is not available. Issue 1 (5th August 2013)

• Record Type: Journal Article
• Authors: Kedev, Sasko; Zafirovska, Biljana; Dharma, Surya; Petkoska, Danica
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 1(2014:Jan. 01)
• Page Start: E51
• Page End: E60
• Publication Date: 2013-08-05
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25123
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25123-sec-0001" sec-type="section"> <title>Objectives</title> <p>We evaluated the safety and feasibility of transulnar approach when ipsilateral radial access was not available.</p> </sec> <sec id="ccd25123-sec-0002" sec-type="section"> <title>Methods and Results</title> <p>From March 2011 until February 2013, 476 consecutive patients who underwent transulnar catheterization were included in a single center prospective registry of effectiveness and safety. Diagnostic coronary angiography accounted for 42% of cases, percutaneous coronary intervention (PCI) for 38%, and 17% underwent carotid artery stenting. A subgroup analysis was done in 240 patients with documented ipsilateral radial artery occlusion (RAO). Procedural success was 97% with a crossover rate of 3% to transfemoral access. Hand ischemia was not observed in any patient on day 1 after procedure and on 1 month follow‐up. None of the patients showed ulnar nerve injury. Two patients developed major forearm hematoma that resolved without clinical consequences. Minor access site hematoma occurred in 8%. Severe clinical spasm occurred in two patients. Asymptomatic ulnar artery occlusion at 1 month follow‐up was detected in 3.1%. There was no difference between patients with or without RAO in terms of procedural success and any vascular complication.</p> </sec> <sec id="ccd25123-sec-0003" sec-type="section"> <title>Conclusion</title> <p>Transulnar approach is safe and feasible alternative wrist access when performed by experienced radial operators, providing high success rate and low incidence of vascular complications. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>