BACKGROUND: The use of the transradial approach is associated with low rates of complications at the puncture site, reduced costs, shorter hospital stay and is more confortable to the patient. However, its is not feasible in 5%15% of the cases due to significant anatomic variations, vessel spasms and negative results in the Allen's test. The aim of this study was to evaluate the safety and efficacy of the transulnar access as an alternative approach in these situations. METHODS: Coronary procedures performed through the transulnar approach were included in a prospective registry. We evaluated the success rates, defined as adequate coronary opacity in coronary angiography or a percutaneous coronary intervention (PCI) with residual stenosis < 30%, with no need to change the access site; procedure and fluoroscopy times and the rate of in-hospital and 30-day complications. RESULTS: Between May 2007 and May 2008, 102 coronary procedures were included in the registry. The mean age was 61 ± 11 years, 53% were female patients and 34% were diabetic. Success rates were 94.5% and 100% for coronary angiography and PCI, respectively. There was a low rate of complications, including 2% of asymptomatic occlusion of the ulnar artery and 1% of hematoma not requiring vascular repair or blood transfusion. CONCLUSIONS: The use of transulnar access in coronary procedures is safe and efficient, with high success rates and virtually no complications related to the puncture site. It is a good alternative for those experienced with the transradial approach.
Ulnar artery; Heart catheterization; Percutaneous transluminal coronary angiography; Coronary angiography
