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Is the Complication Rate of Ulnar and Radial Approaches for Coronary Artery Intervention the Same?

Xile Bi1, Qingsheng Wang1, Defeng Liu1

  • 11 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.

Angiology
|April 8, 2017
PubMed

Insights

Transulnar artery access for coronary procedures shows a lower rate of arterial occlusion compared to transradial access. While transulnar access reduces occlusion, it increases hematomas and discomfort.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Transradial artery (RA) access is common for coronary procedures.
  • Transulnar artery (UA) access is an alternative approach.
  • Comparing clinical outcomes between RA and UA access is important for patient safety and procedural success.

Purpose of the Study:

  • To compare the clinical outcomes of transulnar versus transradial artery approaches for coronary interventions.
  • To determine the incidence of arterial occlusion and other complications associated with each approach.

Main Methods:

  • A single-center, randomized study involving 538 patients undergoing coronary artery intervention.
  • Patients were randomized to either the radial artery (RA) or ulnar artery (UA) group.
  • Primary outcome was arterial occlusion of a forearm artery; secondary outcomes included hematomas and discomfort.

Main Results:

  • Arterial occlusion occurred in 9.3% of the RA group versus 2.7% of the UA group (P = .007), with UA access showing a significantly lower rate.
  • Higher risk of occlusion was associated with repeated procedures, smoking, and a low arterial to sheath diameter ratio.
  • Transulnar access was associated with a higher incidence of hematomas (13.2% vs 5.8%, P = .01) and discomfort (15.5% vs 5.8%, P = .002).

Conclusions:

  • Transulnar artery access is noninferior to transradial artery access for coronary procedures regarding arterial occlusion.
  • The choice of access may depend on balancing the risk of occlusion against the potential for increased hematomas and discomfort.

Keywords:
coronary artery diseasepercutaneous coronary interventionradial arteryrisk factorsulnar artery

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