Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study

Background: coronary angiography is the gold standard method for diagnosis of coronaryheart disease and usually performed by femoral approach that has several complications. toreduce these complications, upper extremity approach is increasingly used and is becomingpreferred access site by many interventionists. although radial approach is relatively wellstudied, safety, feasibility and risk of applying ulnar approach in not clearly known yet.methods: we followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18)who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 monthsand recorded their outcomes.results: in 97 patients out of 105 ones (92.38%), procedure through ulnar access weresuccessfully done. unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet(2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. in94 patients (89.52%), the angiography and angioplasty was done without any complications.five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolvedwith painkiller. no infection, amputation or need for surgery was reported.conclusion: this study demonstrated that ulnar access in our patients was a safe andpractical approach for coronary angiography or angioplasty, without any major complication.bearing in mind its high success rate, it can be utilized when a radial artery is not useful for thecatheterization and in cases such as prior harvesting of the radial artery (in prior coronary arterybypass grafting).