Background:
Pioneering publications discourage the use of ulnar access after failed attempt to obtain ipsilateral radial access.
Methods:
Prospective efficacy and safety registry comparing the incidence of bleeding and vascular complications in patients with an initial intention to use ulnar access and those who used this access after a failed attempt to cannulate the ipsilateral radial artery.
Results:
Between May 2007 and December 2013, 11,825 invasive coronary procedures were performed at a single center, 473 (4%) of them by ulnar access. In 65 cases, the ulnar artery cannulation was preceded by a failed attempt to obtain the ipsilateral radial access. The technical success rate was higher than 98%, with low complication rates, mostly due to superficial hematomas, and no differences between groups. There were no cases of major bleeding related to the access site, pseudoaneurysm, arteriovenous fistula or injury to the adjacent ulnar nerve.
Conclusions:
The ulnar access is a safe and effective alternative to perform selected invasive coronary procedures, despite previous attempts to obtain the ipsilateral radial access.
Ulnar artery; Radial artery; Coronary angiography; Percutaneous coronary intervention; Hemorrhage