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Efficacy and safety of transulnar coronary angiography and interventions--a single center experience
Anand R Deshmukh1, Manu Kaushik, Ahmed Aboeata
1Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska.
Insights
The transulnar approach is a safe and effective method for complex coronary interventions, demonstrating high success rates and favorable long-term safety outcomes in patients. This study confirms its efficacy in coronary angiography and interventions.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Access
Background:
- The efficacy and long-term safety of the transulnar approach for complex coronary interventions require further validation.
- Limited data exists on the outcomes of transulnar access in advanced percutaneous coronary interventions.
Purpose of the Study:
- To assess the efficacy and long-term safety of the transulnar approach in performing complex coronary angiography and interventions.
- To evaluate procedural success rates and identify potential complications associated with transulnar access.
Main Methods:
- Retrospective review of 81 patients undergoing transulnar coronary angiography and interventions between January 2004 and July 2009.
- Primary endpoint: procedural success rate. Secondary endpoints: major bleeding, local vascular/neurological complications, cerebrovascular accident (CVA)/transient ischemic attack (TIA), myocardial infarction (MI), and major adverse cardiovascular events (MACE).
Main Results:
- Successful transulnar access, angiography, and interventions were achieved in 93.8%, 100%, and 92.6% of cases, respectively.
- Interventions included 12% on coronary bypass grafts and 9.2% on the left main coronary artery.
- At 1-year follow-up, vascular complication rates were low (2.8% at 30 days), with no residual deficits, and an overall MACE rate of 3.4%.
Conclusions:
- The transulnar approach is a safe and effective option for complex coronary angiography and interventions.
- This study provides initial evidence for the feasibility and positive long-term safety profile of the transulnar approach in interventional cardiology.
Objectives:
To evaluate the efficacy and long-term safety of transulnar approach in complex coronary interventions.
Background:
The success rate of transulnar approach in complex coronary interventions and its long-term safety remains to be proven.
Methods:
We conducted a retrospective chart review of patients undergoing transulnar coronary angiography and interventions at our institution from January 2004 through July 2009. Primary endpoint of the study was the success rate of the procedure. Secondary endpoints were major bleeding, local vascular and neurological complications, cerebrovascular accident (CVA)/transient ischemic attack (TIA), myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE) rate that was a composite of MI, CVA/TIA, and all-cause mortality.
Results:
Of 81 patients undergoing transulnar approach, 41 (50.6%) patients underwent intervention on 65 lesions. Twelve percent of the interventions were performed on coronary bypass grafts and 9.2% on the left main coronary artery. Success rates for transulnar access, coronary angiography, and coronary/bypass graft interventions were 93.8%, 100%, and 92.6%, respectively. Follow-up data was available on 71 patients at short term (30 days) and 58 patients at long term (1 year). At 30-day follow-up, vascular complication rate was 2.8 %. At 1-year follow-up, there were no residual deficits from vascular or neurological complications associated with the index procedure and the overall MACE rate was 3.4%.
Conclusion:
In this first study evaluating long-term safety and feasibility of transulnar coronary angiography and complex coronary interventions, we conclude that transulnar approach appears to be safe and effective.
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