Primary percutaneous coronary intervention through transulnar approach: safety and effectiveness

Area of Science:

• Interventional Cardiology
• Vascular Access Techniques
• Anatomical Variations

Background:

• The transradial approach is standard for coronary procedures but can be limited by radial artery anatomy or spasm.
• Anatomical variations and a negative Allen's test can contraindicate transradial access.
• The transulnar approach presents a potential alternative vascular access route.

Observation:

• A patient presented for primary angioplasty.
• The ipsilateral radial artery was found to be occluded.
• Access was successfully obtained via the ulnar artery.

Findings:

• Primary angioplasty was performed using the transulnar approach.
• The procedure was completed without any ischemic hand complications.
• This highlights the viability of the ulnar artery for vascular access.

Implications:

• The transulnar approach is a safe and effective alternative in cases unsuitable for transradial access.
• Ulnar artery access can be considered even with ipsilateral radial artery occlusion.
• This expands options for complex coronary interventions requiring alternative vascular access.