title: Is the Complication Rate of Ulnar and Radial Approaches for Coronary Artery Intervention the Same?
abstract: We compared the clinical outcomes of patients who underwent coronary artery intervention by the transulnar and transradial artery approaches. In this 1 year, single-center study, patients were randomized to either a radial artery (RA) or ulnar artery (UA) group. Of 538 patients, the primary outcome, arterial occlusion of a forearm artery, occurred in 21 of 225 patients in the RA group compared to 6 of 220 patients in the UA group (9.3% vs 2.7%, P = .007). The rate of arterial occlusion was significantly lower following ulnar access compared to radial (odds ratio [OR] = 3.85, P = .006). A higher risk of occlusion was associated with repeated procedures rather than a single procedure (OR = 5.14, P = .003), smoking (OR = 2.39, P = .04), and arterial to sheath diameter ratio of ≤1 (OR = 2.62, P = .03). However, the disadvantage of UA was an increase of incidence of hematomas (13.2% vs 5.8%, P = .01) and symptoms of discomfort (15.5% vs 5.8%, P = .002). In conclusion, the transulnar strategy proved to be noninferior to the transradial approach for coronary procedures ( ClinicalTrials.gov Identifier: NCT01979627).
authors.affiliation: 1 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Xile
authors.initials: X
authors.lastname: Bi
authors.affiliation: 1 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Qingsheng
authors.initials: Q
authors.lastname: Wang
authors.affiliation: 1 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Defeng
authors.initials: D
authors.lastname: Liu
authors.affiliation: 1 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Gan
authors.affiliation: 1 Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
mesh_terms: D017023:Coronary Angiography / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D011677:Punctures; D017534:Radial Artery; D017535:Ulnar Artery
keywords: coronary artery disease; percutaneous coronary intervention; radial artery; risk factors; ulnar artery