title: Transulnar approach: the rationale from the radialist's view.
abstract: BACKGROUND
  Radial access, besides providing greater comfort to the patient and reduction of hospital costs, promotes unequivocal reduction of vascular complications, with possible prognosis implication. A series of cases has shown that when its use is not suitable, ulnar access presents itself as a viable and effective alternative.
  
  
  OBJECTIVE
  To evaluate the safety and effectiveness of ulnar approach in the performance of coronary procedures after failed attempt in obtaining radial access.
  
  
  RESULTS
  From May 2007 to February 2009, 115 patients underwent 122 coronary procedures via ulnar access and were included in a prospective registry. The average age was 61.3 +/- 11.1 years, 67 (58%) were female and 36 (31%) were diabetic. Procedure success was achieved in 116 (95%) cases. There were no cases of major bleeding, transfusions or vascular repair surgery among the complications. There were hematomas in 4.9% of the cases, though mostly superficial, light to moderate spasms in 4% and asymptomatic ulnar artery occlusion, with no evidence of ischemia in 1.6%.
  
  
  CONCLUSIONS
  The ulnar artery is a feasible and effective alternative approach to perform coronary procedures. When radial access is not available, it presents a similar safety profile with virtually no occurrence of hemorrhagic complications.
authors.affiliation: Santa Casa de Marília, Marília, SP, Brazil. pedroberaldo@gmail.com
authors.forename: Pedro Beraldo
authors.initials: PB
authors.lastname: de Andrade
authors.forename: Marden André
authors.initials: MA
authors.lastname: Tebet
authors.forename: Mônica Vieira Athanazio
authors.initials: MV
authors.lastname: de Andrade
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Piva e Mattos
authors.forename: André
authors.initials: A
authors.lastname: Labrunie
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery; D012042:Registries; D016896:Treatment Outcome; D017535:Ulnar Artery