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Percutaneous ulnar artery approach for coronary angiography: a preliminary report in nine patients
M Terashima1, T Meguro, H Takeda
1Heart Center, Sendai Kosei Hospital, 4-15 Hirose-machi, Aoba-Ku, Sendai 980-0873, Japan. uh9t-tsm@asahi-net.or.jp
Insights
A novel percutaneous ulnar artery approach for coronary angiography offers a safe alternative to the radial artery, especially for patients with inadequate ulnar artery supply. This method shows comparable procedure times and no observed complications.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Access
Background:
- The radial artery approach is increasingly preferred for cardiac catheterization due to fewer complications and improved patient comfort.
- However, inadequate ulnar artery blood supply, identified by Allen's test, excludes 10%-30% of patients from this approach.
Purpose of the Study:
- To evaluate a new percutaneous ulnar artery approach for coronary angiography.
- To assess the feasibility, safety, and efficacy of this alternative vascular access technique.
Main Methods:
- A novel percutaneous ulnar artery cannulation technique was employed in nine patients.
- Coronary angiography was performed via the ulnar artery access site.
- Procedure times and complications were monitored.
Main Results:
- Successful ulnar artery access was achieved in seven out of nine patients.
- Cannulation and procedure times were comparable to established radial artery approaches.
- No complications, including bleeding, pulse loss, nerve injury, aneurysm, or fistula, were observed.
Conclusions:
- The percutaneous ulnar artery approach is a viable alternative for coronary angiography.
- It offers reduced patient discomfort and risk while preserving the radial artery for potential future coronary artery bypass grafting.
- This technique expands options for vascular access in cardiac procedures.
Abstract:
The radial artery approach is becoming more popular for diagnostic cardiac catheterization and interventional procedures because of its lower incidence of access site complications and decreased patient discomfort after the procedure. However, Allen's test reveals inadequate blood supply through the ulnar artery to the hand, and therefore the approach does not seem to be suitable in 10%-30% of patients. Here we demonstrated a new percutaneous ulnar artery approach for coronary angiography in nine patients. We succeeded in obtaining an entry site into the left ulnar artery in seven patients. The average time for cannulation and that for catheterization procedure were comparable with those of the radial approach previously reported from other laboratories. Complications such as bleeding, loss of an ulnar pulse, ulnar nerve injury, and the formation of an aneurysm or fistula were not observed in any patient. The ulnar approach may be another technique that decreases patient discomfort and risk, while preserving the radial artery as a potential coronary bypass graft for surgical myocardial revascularization. Cathet Cardiovasc Intervent 2001;53:410-414.