title: Efficacy and safety of transulnar coronary angiography and interventions--a single center experience.
abstract: OBJECTIVE
  To evaluate the efficacy and long-term safety of transulnar approach in complex coronary interventions.
  
  
  BACKGROUND
  The success rate of transulnar approach in complex coronary interventions and its long-term safety remains to be proven.
  
  
  METHODS
  We conducted a retrospective chart review of patients undergoing transulnar coronary angiography and interventions at our institution from January 2004 through July 2009. Primary endpoint of the study was the success rate of the procedure. Secondary endpoints were major bleeding, local vascular and neurological complications, cerebrovascular accident (CVA)/transient ischemic attack (TIA), myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE) rate that was a composite of MI, CVA/TIA, and all-cause mortality.
  
  
  RESULTS
  Of 81 patients undergoing transulnar approach, 41 (50.6%) patients underwent intervention on 65 lesions. Twelve percent of the interventions were performed on coronary bypass grafts and 9.2% on the left main coronary artery. Success rates for transulnar access, coronary angiography, and coronary/bypass graft interventions were 93.8%, 100%, and 92.6%, respectively. Follow-up data was available on 71 patients at short term (30 days) and 58 patients at long term (1 year). At 30-day follow-up, vascular complication rate was 2.8 %. At 1-year follow-up, there were no residual deficits from vascular or neurological complications associated with the index procedure and the overall MACE rate was 3.4%.
  
  
  CONCLUSIONS
  In this first study evaluating long-term safety and feasibility of transulnar coronary angiography and complex coronary interventions, we conclude that transulnar approach appears to be safe and effective.
authors.affiliation: Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska.
authors.forename: Anand R
authors.initials: AR
authors.lastname: Deshmukh
authors.forename: Manu
authors.initials: M
authors.lastname: Kaushik
authors.forename: Ahmed
authors.initials: A
authors.lastname: Aboeata
authors.forename: Jamil
authors.initials: J
authors.lastname: Abuzetun
authors.forename: Tammy L
authors.initials: TL
authors.lastname: Burns
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Nubel
authors.forename: Michael D
authors.initials: MD
authors.lastname: White
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Lanspa
authors.forename: Claire B
authors.initials: CB
authors.lastname: Hunter
authors.forename: Aryan N
authors.initials: AN
authors.lastname: Mooss
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Esterbrooks
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000209:etiology; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D009329:Nebraska; D009422:Nervous System Diseases / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D017535:Ulnar Artery
keywords: coronary interventions; efficacy; safety; transulnar approach