Safety and feasibility of transulnar cardiac catheterization.

Recently, ulnar artery cannulation has been described as an alternative to the transfemoral and radial approaches to vascular access for cardiac catheterization. This study was designed to evaluate the safety and feasibility of the ulnar approach.From September 2004 through September 2006, 28 patients in a cohort study underwent cardiac catheterization by the transulnar approach. Patients were eligible if they had scheduled an elective cardiac catheterization or angioplasty procedure and displayed a palpable ulnar pulse and a positive reverse Allen's test (< 10 sec). Further, we enrolled only patients who had stable angina. After cannulation, a 5F or 6F introducer was placed inside the vessel, and cardiac catheterization or angioplasty was performed. The patients underwent clinical examination when discharged from the hospital and again at the 1-week follow up.Mean age, weight, and height of the patients were 60 +/- 14 years, 78 +/- 14 kg, and 148 +/- 55 cm, respectively, and 69% were men. Successful puncture was achieved in 93% (26/28), and in all 26 of these patients the procedure could be completed by the ulnar approach. The femoral approach was used for the remaining 2 patients. No cases of arterial spasm or loss of pulse were observed. Two patients had minor hematoma at the entry site. There were no cases of pseudoaneurysm, bleeding episodes requiring transfusion, or vascular perforation.We conclude that the transulnar approach is a safe and feasible alternative for diagnostic and therapeutic coronary intervention.