A Comparative Study of Transulnar and Transradial Artery Access for Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

Abstract

The TUI approach has results and access complications similar to the TRI approach and is a safe and feasible alternative for ACS patients.

Transulnar versus transradial access for coronary angiography or percutaneous coronary intervention: A meta‐analysis of randomized controlled trials

“…The RCTs that compared TUA versus TRA reached different conclusions [10,16]. The largest RCT by Hahalis et al did not recommend the use of TUA as either a default or an alternative access site to TRA owing to higher access cross-over rates with TUA while other published RCTs concluded that TUA could be safely used in patients undergoing coronary procedures including primary PCI [12,17]. Therefore, to evaluate the safety and efficacy of TUA versus TRA in patients undergoing CA or PCI, we performed a meta-analysis of the available RCTs.…”

“…Tables I and II, respectively, show the individual study and patient characteristics, and procedural angiographic data. In two studies [10,12] abnormal Allen's or reverse Allen's test was an exclusion criteria, in another two [11,16] the patients were randomized regardless of Allen's test or reverse Allen's test results and in one study [17] there was no mention of Allen's test but they had utilized Doppler ultrasound to assess forearm vessels before the procedure. The PCI success by establishment of thrombolysis in myocardial infarction grade 3 flow was similar between two strategies in all studies.…”

“…We screened 580 publications for eligibility after removal of 108 duplicates. Finally, we extracted 23 studies for full-text review, of which 5 RCTs [10][11][12]16,17] with 2,744 total patients (TUA arm: n ¼ 1,384 and TRA: n ¼ 1,360) were included in the meta-analysis.…”

“…Several single arm studies and randomized controlled trials (RCTs) have evaluated TUA in patients undergoing coronary procedures [5,6,[11][12][13][14][15]. The RCTs that compared TUA versus TRA reached different conclusions [10,16].…”

Flow and Diameter Changes of Forearm Arteries During Temporary Unilateral Reciprocal Occlusion: A Prospective Observational Study

“…Arterial perfusion of the wrist is provided mainly by the radial artery (RA) and the ulnar artery (UA), which are the preferred vascular access for interventional procedures . The carpal network receives an accessory contribution from the distal branches of the anterior and posterior interosseous arteries of the forearm.…”