Author + information
- Nagaraja Moorthy,
- Rajiv Ananthakrishna,
- P.V. Dattatreya,
- Rangaraj Ramalingam and
- C.N. Manjunath
Background: Failed transradial approach(TR) is observed in up to 5% of the patients due to various anatomical reasons. In such selected cases, crossover to the ipsilateral ulnar artery (TU) may be considered.
Objective of the Study: To study the safety and feasibility of crossover from transradial to ipsilateral transulnar access in difficult radial artery anatomy.
Methods: Prospective observational study included 18 patients undergoing ipsilateral transulnar crossover after failed radial access.
Results: Challenging radial artery anatomy: Uncrossable radial artery loop was noted in 8 patients. Six had high radial artery take off (2 from subclavian artery, 4 from brachial artery) and 4 had diffuse caliber radial artery.
Procedure: When the catheter or wire advancement failed the anatomy of radial, ulnar and brachial artery were studied using Injection (Figure 1A-F). In all cases ulnar artery anatomy was favorable. The radial sheath (6F Terumo) was left in situ and Ulnar artery access(Figure-1G) was obtained and sheath was inserted. The diagnostic coronary angiography was done in all and 6 cases underwent adhoc angioplasty. After the procedure both sheaths were removed achieving proper haemostasis (Picture-1H). In all 18 cases transulnar procedure was successful with no procedure related complications like bleeding, haematoma or ischemia.
Conclusions: Crossover to ipsilateral transulnar access after transradial failure strictly due to anomalies of the radial artery is feasible and safe.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Access and Hemostasis Issues
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1192-129
- 2017 American College of Cardiology Foundation