Ulnar-artery access versus radial-artery access in coronary-artery angiography and interventions

Introduction The use of radial-artery access for percutaneous coronary angiography and interventions is recently adopted by many interventional cardiologists as their default access in coronary procedures. In some patients who have a weak radial pulse, or those who have used the radial artery as a bypass graft during coronary-artery bypass surgery, ulnar access may be a safe and convenient alternative to radial access that allows the operator to use forearm access and avoid crossing over to the femoral approach Aim In this study, we compared the safety and efficacy of ulnar access versus radial access for coronary angiography and interventions. Patients and methods This study was conducted on 100 patients who presented with chronic coronary syndromes and were referred for coronary angiography and percutaneous coronary intervention if needed. They were divided into two groups, group A consisted of 50 patients for which coronary angiography was done through transradial access, and group B consisted of 50 patients for which coronary angiography was done through transulnar access. The complication rate, crossover rate, and patient discomfort were compared in both groups. Results We found that hematoma formation and patient discomfort were found more significantly in the ulnar-access group. Access-artery occlusion was found more significantly in the radial-access group. There was no significant difference between both groups regarding access-artery spasm and crossover. Conclusion The transulnar approach proved to be noninferior to the transradial approach for coronary procedures.