Original Research Article
Year: 2022 | Month: November | Volume: 9 | Issue: 11 | Pages: 226-231
DOI: https://doi.org/10.52403/ijrr.20221130
Safety and Efficacy of Transulnar Route in Percutaneous Coronary Intervention: 30 days follow-up
Raghava Sarma Polavarapu1, MD, DM; Yudhistar Siripuram2, MD, DM; Keerthika Chowdary Ravella3, MD, DM; Anurag Polavarapu4, MD, DM; Kalyan Chakravarthi Pulivarthi5, MD, DM; Hima Sanjana Perumalla6, MBBS; Sai Reshma Magam7, MD; Vijaya Pamidimukkala, MD, DM8
1Interventional Cardiologist, Head of Department, Department of Cardiology, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
2Junior Consultant., Department of Cardiology, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
3Senior Consultant, Department of Cardiology, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
4Senior Resident, Department of Cardiology, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
5Junior Consultant Cardiology, Department of Cardiology, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
6Physician, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
7Resident, Internal Medicine, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
8Head of Department, Department of Neurosciences, Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh -522001, India
Corresponding Author: Raghava Sarma Polavarapu
ABSTRACT
Background Percutaneous coronary intervention (PCI) is the mainstay treatment in patients with coronary artery disease (CAD). The utility of transulnar approach (TUA) has been a topic of debate. Therefore, we aimed to evaluate the safety and efficacy of TUA in this study.
Methods This was a prospective, single-center, interventional study conducted between September 2005 and November 2021 at a tertiary-care center in India. Consecutive patients (≥18 years) with CAD requiring PCI using TUA were enrolled in this study. Patients with a negative Allen’s or reverse Allen’s test (>10 seconds), nonpalpable ulnar artery, cardiogenic shock, and the need for a large guiding catheter were excluded. Patients were clinically followed-up at one week to monitor occlusion and 30 days to observe and manage major adverse cardiovascular events (MACE; composite of myocardial re-infarction, target vessel revascularization, disabling stroke, and death).
Results A total of 200 patients were enrolled in this study with a mean age of 58.2±10.7 years. Majority of patients (38%) belonged to the age group of 56-65 years and this study observed a male predominance (80.5%). Follow-up of one week revealed no anatomical variations of the ulnar artery and there was no trauma to the ulnar nerve. Ulnar occlusion, however, was seen in three (1.5%) patients. Forearm hematoma was observed in one patient which was then managed conservatively. At 30-days follow-up, (MACE) did not occur in any of the patients.
Conclusion In the case that TRA cannot be performed, TUA can be used as a safe and effective alternative access route for PCI, avoiding the transfemoral approach.
Keywords: Coronary artery disease, catheterization, transulnar approach, transradial approach
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