中华医学杂志（英文版）2010，Vol.123Issue(13)：1774-1779,6.DOI:10.3760/cma.j.issn.0366-6999.2010.13.029
Safety and efficacy of transulnar approach for coronary angiography and intervention
Safety and efficacy of transulnar approach for coronary angiography and intervention
LI Yun-zhi 1NIE Bin 1HAN Hong-ya 1HU Bin 1ZHOU Yu-jie 1ZHAO Ying-xin 1GUO Yong-he 1LIU Yu-yang 1SHI Dong-mei 1WANG Zhi-jian 1JIA De-an 1YANG Shi-wei1
作者信息
- 1. Department of Cardiology,Beijing Anzhen Hospital of Capital Medical University,Beijing 100029,China
- 折叠
摘要
Abstract
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 effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.关键词
transulnar approach/transradial approach/coronary angiography/percutaneous coronary interventionKey words
transulnar approach/transradial approach/coronary angiography/percutaneous coronary intervention引用本文复制引用
LI Yun-zhi,NIE Bin,HAN Hong-ya,HU Bin,ZHOU Yu-jie,ZHAO Ying-xin,GUO Yong-he,LIU Yu-yang,SHI Dong-mei,WANG Zhi-jian,JIA De-an,YANG Shi-wei..Safety and efficacy of transulnar approach for coronary angiography and intervention [J].中华医学杂志（英文版）,2010,123(13):1774-1779,6.
