title: Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study.
abstract: BACKGROUND
  Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet.
  
  
  METHODS
  We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes.
  
  
  RESULTS
  In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported.
  
  
  CONCLUSIONS
  This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting).
authors.affiliation: Associate Professor, Department of Cardiology and Intervention, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Roghani-Dehkordi
authors.affiliation: Cardiologist, Intervention Fellowship Practitioner, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Hadizadeh
authors.affiliation: Researcher, Karolinska Institute, Stockholm, Sweden.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Hadizadeh
keywords: Coronary Angiography; Coronary Angioplasty; Outcome of Arterial Access