Background Transradial approach catheterization is now widely used in coronary angiography and angioplasty.The ulnar artery,which is one of the two terminal branches of the brachial artery,may be a potential approach ...Background Transradial approach catheterization is now widely used in coronary angiography and angioplasty.The ulnar artery,which is one of the two terminal branches of the brachial artery,may be a potential approach for cardiac catheterization.The aim of this study was to evaluate the safety and feasibility of a transulnar approach for coronary catheterization in non-selective patients.Methods A total of 535 consecutive patients were randomly assigned to transulnar approach （TUA） group （n=271） or transradial approach （TRA） group （n=264） upon arrival at the catheterization laboratory.Allen＇s test and inverse Allen＇s test were not routinely performed.Ultrasound-Doppler assessment of the forearm artery was performed before the procedure,two days after the procedure,and 30 days after the procedure.The primary endpoints of study were the rate of successful artery cannulation and the access-site related complications.The secondary endpoints included the number of needle punctures,total time for the procedure,and major adverse cardiac events （MACE）.Results Successful puncture of the objective artery was obtained in 91.5％ of the patients in the TUA group,and 95.1％ of the patients in the TRA group （P ＞0.05）.There was no significant difference in hematoma complications between the two groups （7.7％ vs.4.2％,P=0.100）.A motor abnormality of the hand was observed in one patient in the TUA group.There were no arteriovenous fistula or pseudoaneurysm observed in our study.Three （1.1％） patients in the TUA group and 8 （3.0％） patients in the TRA group had occlusion of the access artery （P=0.137）,but none of the patients had symptoms or signs of hand ischemia.There were no significant differences in MACE between the two groups during follow-up.Conclusion The transulnar approach is an effective and safe technique for coronary catheterization in non-selective patients.展开更多
Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transuln...Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention. Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar （TUA） or transradial approach （TRA）. Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events （MACE） as secondary end point was recorded till 30 days follow-up. Results Successful puncture was achieved in 98.3% （118/120） of patients in the TUA group, and in 100% （120/120） of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs.12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively （P=0.949）. No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients. Conclusions The transulnar approach is as safe and ef展开更多
文摘Background Transradial approach catheterization is now widely used in coronary angiography and angioplasty.The ulnar artery,which is one of the two terminal branches of the brachial artery,may be a potential approach for cardiac catheterization.The aim of this study was to evaluate the safety and feasibility of a transulnar approach for coronary catheterization in non-selective patients.Methods A total of 535 consecutive patients were randomly assigned to transulnar approach （TUA） group （n=271） or transradial approach （TRA） group （n=264） upon arrival at the catheterization laboratory.Allen＇s test and inverse Allen＇s test were not routinely performed.Ultrasound-Doppler assessment of the forearm artery was performed before the procedure,two days after the procedure,and 30 days after the procedure.The primary endpoints of study were the rate of successful artery cannulation and the access-site related complications.The secondary endpoints included the number of needle punctures,total time for the procedure,and major adverse cardiac events （MACE）.Results Successful puncture of the objective artery was obtained in 91.5％ of the patients in the TUA group,and 95.1％ of the patients in the TRA group （P ＞0.05）.There was no significant difference in hematoma complications between the two groups （7.7％ vs.4.2％,P=0.100）.A motor abnormality of the hand was observed in one patient in the TUA group.There were no arteriovenous fistula or pseudoaneurysm observed in our study.Three （1.1％） patients in the TUA group and 8 （3.0％） patients in the TRA group had occlusion of the access artery （P=0.137）,but none of the patients had symptoms or signs of hand ischemia.There were no significant differences in MACE between the two groups during follow-up.Conclusion The transulnar approach is an effective and safe technique for coronary catheterization in non-selective patients.
文摘Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention. Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar （TUA） or transradial approach （TRA）. Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events （MACE） as secondary end point was recorded till 30 days follow-up. Results Successful puncture was achieved in 98.3% （118/120） of patients in the TUA group, and in 100% （120/120） of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs.12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively （P=0.949）. No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients. Conclusions The transulnar approach is as safe and ef
