A randomized trial comparing left distal radial versus femoral approach for coronary artery bypass graft angiography: a pilot study

Aksoy, Muhammed Necati Murat; Sahinkus, Salih; Ağaç, Mustafa Tarık; Tatlı, Ersan

doi:10.23736/s2724-5683.21.05626-x

Cited by 1 publication

(1 citation statement)

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“…Safety and feasibility of obtaining a homolateral ulnar approach in cases of radial approach failure have already been demonstrated in a prospective multicentre European registry wherein same-limb ulnar access was obtained successfully in 85.7% of patients having failed radial cannulation without any evidence of early limb ischemia [ 3 ]. Another modification which can be employed to avoid risking arm ischemia is to cannulate distal radial artery instead of proximal main radial artery as it prevents proximal arterial occlusion and does not jeopardizes hand circulation with simultaneous ulnar artery access ensuring successful passage as it is of relatively larger bore, less tortuous, devoid of loops and has relatively straighter course less liable for arterial spasm [ 4 – 8 ]. Vascular access-site complications viz.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous radio-ulnar cannulation: shifting gears from ‘feasibility’ to ‘applicability’

2021

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Conventionally, routes of vascular access commonly include femoral and radial arteries with brachial, ulnar and subclavian arteries being rarely used for coronary interventions. Non-femoral arterial access is being increasingly preferred to minimise groin puncture site complications, prolonged immobilization and duration of hospital stay. However, radial artery cannulation is also fraught with fears of tortuosity, loops, vascular spasm, perforation, pseudoaneurysm formation, arm hematoma and arterial occlusion. In contemporary practice when most of the coronary procedures are being done via transradial access, encountering one of the above-mentioned hurdles often forces the operator to switchover to femoral access. Here, we explore the rationale, feasibility, operational logistics, clinical implications and future directions for using simultaneous radio-ulnar arterial access in the same extremity.

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Section: Discussionmentioning

confidence: 99%