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

Area of Science:

• Vascular access techniques
• Interventional cardiology
• Anatomical studies

Background:

• The ulnar artery is comparable in size to the radial artery but presents greater palpation and access challenges.
• Trans-ulnar access (TUA) is an alternative to trans-radial access (TRA) for physicians skilled in its use, particularly when TRA is suboptimal or fails.

Purpose of the Study:

• To describe the anatomy, technique, procedural success, and complications associated with trans-ulnar access (TUA).
• To evaluate TUA as an alternative vascular access site for interventional procedures.

Main Methods:

• Review of data from single-center registries and randomized studies.
• Description of the anatomical considerations and suggested procedural technique for TUA.

Main Results:

• Trans-ulnar access (TUA) demonstrates a lower and more variable success rate compared to trans-radial access (TRA).
• Both TUA and TRA exhibit similar safety profiles and complication rates.
• TUA provides an alternative when TRA is difficult or unsuccessful.

Conclusions:

• Interventionalists should consider learning and mastering TUA to enhance success rates for wrist-based interventions.
• TUA can help avoid the complications, discomfort, and costs associated with trans-femoral approaches.
• Mastering TUA expands procedural options and improves patient outcomes.