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Complications Following Ulnar Artery Catheterization for Coronary Angiography
Mackenzie B Grasso1, Jillian McLaughlin1, Michael F Amendola1,2
1Virginia Commonwealth University School of Medicine, Richmond, USA.
Insights
Ulnar artery catheterization for percutaneous procedures carries significant risks, including hematoma, nerve damage, and ischemia. A review found 41% of patients experienced complications, some requiring surgery.
Area of Science:
- Cardiovascular Interventions
- Vascular Access Procedures
Background:
- Radial and ulnar artery access is increasingly used for percutaneous procedures.
- Ulnar artery catheterization poses risks such as pseudoaneurysm, hematoma, compartment syndrome, nerve injury, and hand ischemia.
Purpose of the Study:
- To describe complications specific to ulnar artery catheterization.
Main Methods:
- Retrospective review of patients undergoing ulnar artery catheterization between 2019-2021.
- Assessment of complications and comparison with prior published data.
Main Results:
- 41% of 41 patients experienced immediate postprocedural complications.
- Common complications included hematoma (29%), ulnar neuropathy (7%), and compartment syndrome (5%).
- Three patients (7%) required operative intervention.
Conclusions:
- Ulnar artery catheterization is associated with significant risks for percutaneous procedures.
- Complications range from pseudoaneurysm and hematoma to critical hand ischemia.
- Some patients required surgical intervention and experienced persistent ulnar nerve symptoms.
Background:
Use of radial and ulnar access has increased due to its perceived benefits over femoral access. Ulnar artery catheterization can place patients at risk of significant complications, including pseudoaneurysm, expanding hematoma, compartment syndrome, ulnar nerve injury, and critical hand ischemia. The purpose of this study was to describe complications specific to ulnar artery catheterization.
Methods:
After obtaining institutional review board approval, a retrospective review was performed on all patients who underwent ulnar artery catheterization at our institution between 2019 and 2021. Complications were assessed, and complication rates were compared with previously published studies on ulnar artery catheterization for coronary angiography (percutaneous coronary intervention).
Results:
A total of 41 patients were available for review with a mean age of 59 years. Of these, 17 patients (41%) sustained complications in the immediate postprocedural period. These complications included hematoma (12 patients, 29%), pseudoaneurysm (1 patient, 2%), ulnar artery thrombosis (1 patient, 2%), ulnar neuropathy (3 patients, 7%), arterial damage requiring repair (2 patients, 5%), transient ischemia (3 patients, 7%), and compartment syndrome (2 patients, 5%). Three of these patients (7%) required operative intervention, and several were admitted to the hospital for an additional period of observation.
Conclusions:
This series highlights the significant risks associated with ulnar artery catheterization for percutaneous procedures. Complications include pseudoaneurysm, expanding hematoma, compartment syndrome, ulnar nerve damage, and critical hand ischemia. Several of these patients required urgent or emergent surgical intervention, with some patients experiencing ongoing ulnar nerve symptoms.
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