The transulnar approach in the patients with ipsilateral radial artery occlusion.

Coronary Angiography Percutaneous Coronary Intervention Radial Artery Ulnar Artery

Journal

ARYA atherosclerosis
ISSN: 1735-3955
Titre abrégé: ARYA Atheroscler
Pays: Iran
ID NLM: 101487337

Informations de publication

Date de publication:
Jan 2020
Historique:
entrez: 6 6 2020
pubmed: 6 6 2020
medline: 6 6 2020
Statut: ppublish

Résumé

Transulnar approach (TUA) has been classified as an appropriate surrogate for the transradial approach (TRA), but the safety of TUA in the presence of ipsilateral radial artery occlusion (RAO) is not well studied. In this article, we aimed to assess the feasibility and occurrence of complications of this approach in Iranian individuals with ipsilateral RAO. In this prospective double-center study, a total number of 70 participants from July 2017 to November 2018 with coexisting ipsilateral RAO due to prior RA angiography, severe arterial spasm, prominent vascular anomalies, or arterial harvesting for hemodialysis or graft procedures were enrolled and underwent TUA. Incidence of probable complications including pain, hematoma, arteriovenous fistula (AVF), pseudoaneurysm formation, any adverse events requiring immediate vascular surgery, life-threatening hand ischemia, infection, ulnar nerve palsy, major adverse cardiac events (MACE) including death, myocardial infarction (MI), or stroke plus ulnar artery (UA) obstruction and narrowing was evaluated both before discharge time and one month afterward. The mean age of the study population was 68.2 ± 12.8 years [men number: 41 (58.5%)]. Our success rate was 98.6% and 37.1% of subjects underwent further coronary intervention. No aforementioned adverse outcomes were reported in any individual except for pain (11.4%) and minor hematoma (grade I) (5.7%) as well as MACE (1.4%). Follow-up assessment revealed asymptomatic UA occlusion (UAO) and severe narrowing in 2.8% and 1.4% of participants, respectively. Our outcomes suggested that due to high safety and low complication rates, TUA could be tried safely in patients with concurrent ipsilateral RAO. Other appropriate cohort studies are required for assessing the incidence of TUA complications.

Sections du résumé

BACKGROUND BACKGROUND
Transulnar approach (TUA) has been classified as an appropriate surrogate for the transradial approach (TRA), but the safety of TUA in the presence of ipsilateral radial artery occlusion (RAO) is not well studied. In this article, we aimed to assess the feasibility and occurrence of complications of this approach in Iranian individuals with ipsilateral RAO.
METHODS METHODS
In this prospective double-center study, a total number of 70 participants from July 2017 to November 2018 with coexisting ipsilateral RAO due to prior RA angiography, severe arterial spasm, prominent vascular anomalies, or arterial harvesting for hemodialysis or graft procedures were enrolled and underwent TUA. Incidence of probable complications including pain, hematoma, arteriovenous fistula (AVF), pseudoaneurysm formation, any adverse events requiring immediate vascular surgery, life-threatening hand ischemia, infection, ulnar nerve palsy, major adverse cardiac events (MACE) including death, myocardial infarction (MI), or stroke plus ulnar artery (UA) obstruction and narrowing was evaluated both before discharge time and one month afterward.
RESULTS RESULTS
The mean age of the study population was 68.2 ± 12.8 years [men number: 41 (58.5%)]. Our success rate was 98.6% and 37.1% of subjects underwent further coronary intervention. No aforementioned adverse outcomes were reported in any individual except for pain (11.4%) and minor hematoma (grade I) (5.7%) as well as MACE (1.4%). Follow-up assessment revealed asymptomatic UA occlusion (UAO) and severe narrowing in 2.8% and 1.4% of participants, respectively.
CONCLUSION CONCLUSIONS
Our outcomes suggested that due to high safety and low complication rates, TUA could be tried safely in patients with concurrent ipsilateral RAO. Other appropriate cohort studies are required for assessing the incidence of TUA complications.

Identifiants

pubmed: 32499829
doi: 10.22122/arya.v16i1.2016
pii: ARYA-16-033
pmc: PMC7244791
doi:

Types de publication

Journal Article

Langues

eng

Pagination

33-38

Informations de copyright

© 2020 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.

Références

Arq Bras Cardiol. 2008 Oct;91(4):e49-52, e41-4
pubmed: 19009167
Anesth Analg. 2009 Dec;109(6):1763-81
pubmed: 19923502
Lancet. 2011 Apr 23;377(9775):1409-20
pubmed: 21470671
Cathet Cardiovasc Diagn. 1989 Jan;16(1):3-7
pubmed: 2912567
Cardiovasc Revasc Med. 2017 Jul - Aug;18(5):364-366
pubmed: 28007422
Catheter Cardiovasc Interv. 2001 Jul;53(3):410-4
pubmed: 11458425
ARYA Atheroscler. 2015 Sep;11(5):305-9
pubmed: 26715936
ARYA Atheroscler. 2016 Jan;12(1):10-7
pubmed: 27114732
Catheter Cardiovasc Interv. 2014 Jan 1;83(1):E51-60
pubmed: 23832623
Catheter Cardiovasc Interv. 2016 Apr;87(5):857-65
pubmed: 26332022
Catheter Cardiovasc Interv. 2006 Jun;67(6):870-8
pubmed: 16649233
Catheter Cardiovasc Interv. 2015 Jul;86(1):42-8
pubmed: 25559217
ARYA Atheroscler. 2018 Mar;14(2):95-100
pubmed: 30108641
Int Heart J. 2017 May 31;58(3):313-319
pubmed: 28496021
Heart. 2009 Oct;95(19):1612-8
pubmed: 19596690
Adv Biomed Res. 2017 Dec 26;6:159
pubmed: 29387670
Cardiovasc Revasc Med. 2018 Dec;19(8S):35-40
pubmed: 29628223
JACC Cardiovasc Interv. 2009 Nov;2(11):1057-64
pubmed: 19926044
J Vasc Access. 2017 May 15;18(3):250-254
pubmed: 28430314
Catheter Cardiovasc Interv. 2013 Dec 1;82(7):E849-55
pubmed: 23008162

Auteurs

Farshad Roghani-Dehkordi (F)

Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Hossein Hosseinzadeh (H)

Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Mohammad Kermani-Alghoraishi (M)

Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Alireza Khosravi (A)

Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Mehrbod Vakhshoori (M)

Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Masoumeh Sadeghi (M)

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Manizheh Danesh (M)

Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Nahid Sadeghi (N)

Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Davood Sahfie (D)

Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Classifications MeSH