BACKGROUND: The transradial approach to percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, radial artery occlusion (RAO) limits the ability for repeat catheterization. In current practice, transulnar catheterization is thought to be a contraindication in patients with ipsilateral RAO. METHODS: Seventeen consecutive patients undergoing transulnar catheterization and PCI were reviewed. Each of the patients had clinical follow-up post-procedure at days 1, 7, and 30. RESULTS: We successfully performed 17 ulnar catheterizations in patients with ipsilateral RAO. All patents were subsequently found to have adequate collaterals from the anterior interosseous branch. One patient developed ulnar artery spasm and another patient developed a forearm hematoma. Overall, no patient suffered any ulnar nerve injury. The ulnar artery was patent both by palpation and by the presence of an adequate plethysmographic signal during follow-up at days 1, 7, and 30. No patients developed with any signs or symptoms of hand ischemia during follow-up. CONCLUSION: In patients with RAO, ipsilateral transulnar catheterization may not be an absolute contraindication. Our results suggest that extensive collaterals from the anterior interosseous artery may be the reason for protection against hand ischemia in the setting of RAO.
BACKGROUND: The transradial approach to percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, radial artery occlusion (RAO) limits the ability for repeat catheterization. In current practice, transulnar catheterization is thought to be a contraindication in patients with ipsilateral RAO. METHODS: Seventeen consecutive patients undergoing transulnar catheterization and PCI were reviewed. Each of the patients had clinical follow-up post-procedure at days 1, 7, and 30. RESULTS: We successfully performed 17 ulnar catheterizations in patients with ipsilateral RAO. All patents were subsequently found to have adequate collaterals from the anterior interosseous branch. One patient developed ulnar artery spasm and another patient developed a forearm hematoma. Overall, no patient suffered any ulnar nerve injury. The ulnar artery was patent both by palpation and by the presence of an adequate plethysmographic signal during follow-up at days 1, 7, and 30. No patients developed with any signs or symptoms of hand ischemia during follow-up. CONCLUSION: In patients with RAO, ipsilateral transulnar catheterization may not be an absolute contraindication. Our results suggest that extensive collaterals from the anterior interosseous artery may be the reason for protection against hand ischemia in the setting of RAO.
Authors: Pietro Di Santo; David T Harnett; Trevor Simard; F Daniel Ramirez; Ali Pourdjabbar; Altayyeb Yousef; Robert Moreland; Jordan Bernick; George Wells; Alexander Dick; Michel Le May; Marino Labinaz; Derek So; Pouya Motazedian; Richard G Jung; Jaya Chandrasekhar; Roxana Mehran; Aun-Yeong Chong; Benjamin Hibbert Journal: CMAJ Date: 2018-04-03 Impact factor: 8.262
Authors: Renato Francesco Maria Scalise; Armando Mariano Salito; Alberto Polimeni; Victoria Garcia-Ruiz; Vittorio Virga; Pierpaolo Frigione; Giuseppe Andò; Carlo Tumscitz; Francesco Costa Journal: J Clin Med Date: 2019-10-18 Impact factor: 4.241
Authors: Hesham R Alokaili; Tanveer A Bhat; Tareg M Alhablany; Tuqa A Alsinan; Duaa N Almansour; Felwa A AlMarshad; Abdulla Altamimi; Mohamed Ouhlous; Jawad Alnaqaa Journal: Cureus Date: 2022-08-27