Trans-ulnar catheterization and coronary interventions: From technique to outcomes

The ulnar artery is similar in size to the radial artery, however it is more difficult to palpate and access. For those physicians who mastered trans-ulnar access (TUA) this access site serves as an alternative to trans radial access (TRA) when the radial artery access is rendered suboptimal (by palpation, ultrasound examination or previous procedural records) or when encountering TRA difficulties or failure. The manuscript describes the anatomy, suggested technique, procedural success and complications associated with TUA. Data from single center registries and randomized studies show that TUA has a lower and more variable success rate than TRA, however these 2 approaches carry similar safety profile and complications rates. The authors suggest that interventionalists should consider, learn and master TUA to maintain higher success rate of wrist based interventions while avoiding the potential complications, discomfort and costs of trans-femoral approach.