Feasibility of ulnar artery for cardiac catheterization: AJmer ULnar ARtery (AJULAR) catheterization study
- 3 February 2015
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 86 (1), 42-48
- https://doi.org/10.1002/ccd.25806
Abstract
Abstrac Background: The ulnar artery is rarely selected for cardiac catheterization despite the expanding use of the transradial access (TRA). We tried to compare default transulnar access (TUA) with TRA in terms of feasibility and safety. Materials and methods: This was a prospective, open label, single center, observational study. We analyzed a total of 410 patients with normal Allen's test, who were then scheduled for coronary angiography through TUA with ad hoc PCI if necessary. Procedures were performed by a single operator who had an adequate transradial experience (≥150 transradial coronary procedures per year) but not trained in transulnar procedures. We analyzed observed findings with a retrospective cohort of patients undergoing TRA angiography under a previous study done at our center. We also performed selective ulnar arteriography of 200 patients, through radial route, to predict the bottlenecks of TUA. Observations: There is no statistically significant difference among the number of attempts made till the successful puncture, the total procedure time and the total fluoroscopy time for either radial or ulnar access angiography by an experienced operator (P > 0.05). However, the time taken in arterial access is statistically significant in the initial learning curve for the same (P < 0.05). On the contrary, the arterial access time, the total procedure time, and the total fluoroscopy time, all are statistically significant for the inexperienced operator (P < 0.05). There is a negligible incidence of nonmaneuverable anatomic obstruction in the real‐world scenario in TUA, and so fear of the same should not impede the use of this route. Vasospasm in the use of this route is also not different from the radial route, with the experience of the operator. Conclusions: For an experienced operator, TUA is a safe and also an effective alternative to TRA in terms of feasibility and safety.This publication has 25 references indexed in Scilit:
- Transulnar Compared With Transradial Artery Approach as a Default Strategy for Coronary ProceduresCirculation: Cardiovascular Interventions, 2013
- Sheathless transulnar versus standard femoral arterial access for percutaneous coronary intervention on bifurcation lesionsInternational Journal of Cardiology, 2011
- Feasibility and safety of transulnar access for performing rotational atherectomyInternational Journal of Cardiology, 2011
- Design and rationale of the RadIal Vs. femorAL access for coronary intervention (RIVAL) trial: A randomized comparison of radial versus femoral access for coronary angiography or intervention in patients with acute coronary syndromesAmerican Heart Journal, 2011
- Comparison of the Effect of Intra-Arterial Versus Intravenous Heparin on Radial Artery Occlusion After Transradial CatheterizationThe American Journal of Cardiology, 2009
- Transulnar versus transradial artery approach for coronary angioplasty: The PCVI‐CUBA studyCatheterization and Cardiovascular Interventions, 2006
- Effectiveness of Ulnar Artery Catheterization After Failed Attempt to Cannulate a Radial ArteryThe American Journal of Cardiology, 2005
- Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial: Study design and rationaleAmerican Heart Journal, 2004
- A randomized trial of 5 vs. 6 French transradial percutaneous coronary interventionsCatheterization and Cardiovascular Interventions, 2002