Transulnar is a reasonable alternative to transradial access. This meta-analysis shows that the transulnar route is as safe as transradial, but may be more difficult to successfully perform. Ultrasound imaging can determine whether the radial or ulnar route would be preferable in a particular patient.
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Serial dilation to enable ulnar artery access for endovascular neurointervention: Technical report and systematic review of the literature.
J Stroke Cerebrovasc Dis
November 2024
Department of Neurosurgery, University of California San Diego, 9300 Campus Point Drive MC 7893, San Diego, CA 92037, USA.
Background: For rare neuro-endovascular cases in which transfemoral access is not feasible and the palmar circulation is insufficient for radial artery access, ulnar artery access may be considered.
Materials And Methods: Mechanical thrombectomy via ulnar artery access was performed to preserve the dominant radial artery. The ulnar artery was serial dilated to 7-French with microdilator.
Intraoperative angiography in neurosurgery: temporal trend, access site, and operative indication considerations from a 6-year institutional experience.
J Neurointerv Surg
October 2024
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Background: Historically, the transfemoral approach (TFA) has been the most common access site for cerebral intraoperative angiography (IOA). However, in line with trends in cardiac interventional vascular access preferences, the transradial approach (TRA) and transulnar approach (TUA) have been gaining popularity owing to favorable safety and patient satisfaction outcomes.
Objective: To compare the efficacy and safety of TRA/TUA and TFA for cerebral and spinal IOA at an institutional level over a 6-year period.
Transradial or Transulnar Long Sheath Access to the Brachial Artery Allows for Neuroendovascular Procedures in Patients with Radial or Ulnar Artery Occlusion.
World Neurosurg
January 2024
Department of Neurosurgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida, USA.
Background: Transradial access is an important tool for many neuroendovascular procedures. Occlusion of the radial or ulnar artery is not uncommon after transradial or transulnar access and can present a challenge for patients requiring repeat angiography.
Methods: Between March 2022 and June 2023, patients undergoing transradial or transulnar angiography who were found to have a radial artery occlusion or ulnar artery occlusion were identified.
Cardiovascular Outcomes of Transulnar Versus Transradial Percutaneous Coronary Angiography and Intervention: A Regression Matched Meta-Analysis.
Am J Cardiol
August 2023
Department of Cardiovascular Medicine, West Virginia University, Morgantown, West Virginia. Electronic address:
Transradial access (TRA) and transulnar access (TUA) are in close vicinity, but TRA is the preferred intervention route. The cardiovascular outcomes and access site complications of TUA and TRA are understudied. Databases, including MEDLINE and Cochrane Central registry, were queried to find studies comparing safety outcomes of both procedures.
View Article and Find Full Text PDFWell-palpable pulse over an occluded radial artery: A case series reporting ultrasound outcomes.
J Vasc Access
May 2024
Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland.
We report a case series of four patients with radial artery occlusion complicating vascular access who were scheduled for coronary angiography. We describe the challenges in selecting adequate vascular access in patients with a history of coronary angiography and percutaneous coronary intervention, as well as the benefits of using preprocedural ultrasound examination of forearm arteries to detect radial artery occlusion. Our case series suggests that if the anterior interosseous artery provides partial blood supply to the hand as a collateral circulation of the occluded radial artery, the transulnar approach may be an alternative safe option for coronary angiography and percutaneous coronary intervention in this population.
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