COMPARATIVE STUDY BETWEEN RADIAL AND ULNAR ARTERY ACCESS FOR CORONARY ANGIOGRAPHY AND FOR PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background: Transulnar approach had been suggested for elective procedures in patients not suitable for transradial approach. It is as safe and effective as the transradial approach for coronary angiography and intervention. Objective: To evaluate the safety and feasibility of percutaneous transulnar approach for coronary angiography and intervention. Patient and Methods: This study is a prospective study which was done in Cardiology department of Alazhar University Hospitals and National Heart Institute from the period of July 2019 to July 2020. One hundred patients requiring coronary angiography plus or minus intervention were enrolled and randomly assigned for 2 equal groups: Group I with radial access and Group II with ulnar access. Demographic and comparative analyses of both access sites were obtained. Results: Group II was notably older than Group I (60.9 ± 7.9 versus 57.7 ± 6.7, p= 0.029). There was no difference between the two groups concerning puncture time, number of attempts to fix the artery, procedure and fluoroscopy times. Procedural success rate in both groups was (96% versus 90% in group I and II respectively, p= 0.240) with similar frequency of acute complications as spasm, hematoma or hand ischemia. Vascular anomalies as high takeoff and tortuosities encountered more common in the radial as compared to ulnar group, however, did not reach statistical significance. Conclusion: Transulnar approach was as safe and feasible as transradial access for coronary procedures with similar technical tactic, success and complication rates. However, because of radial artery was more superficial, transulnar access was a realistic alternative to radial route whenever not attainable.