Transulnar versus Transradial Access as a Default Strategy for Percutaneous Coronary Intervention

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Access

Background:

• Percutaneous coronary interventions (PCI) are shifting towards forearm access for improved patient outcomes.
• Transradial access (TRA) is the established forearm approach, but alternatives are being explored.
• Transulnar access (TUA) presents a novel forearm option for interventional cardiologists.

Purpose of the Study:

• To compare the efficacy and safety of TUA versus TRA as a default strategy for PCI.
• To evaluate TUA as an alternative forearm access route in PCI procedures.

Main Methods:

• A prospective, single-center randomized controlled trial.
• 220 patients undergoing PCI were randomized 1:1 to TUA (n=110) or TRA (n=110).
• Primary endpoint: composite of major adverse cardiac events, arterial crossover, major vascular events, and occlusion rate.

Main Results:

• No significant difference in baseline characteristics between TUA and TRA groups.
• Primary endpoint rates were similar: 10.91% for TUA vs. 12.73% for TRA (ITT analysis) and 9.21% for TUA vs. 11.11% for TRA (PP analysis).
• Secondary endpoints, including vessel spasm, also showed no significant differences.

Conclusions:

• Transulnar access (TUA) is an effective alternative to transradial access (TRA) for PCI when performed by experienced operators.
• Utilizing TUA can enhance forearm access success rates and reduce the need for femoral crossover.
• TUA offers a valuable option for interventionalists seeking to optimize PCI procedures.