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

Abstract

For patients requiring CA or PCI, TUA compared with TRA has similar efficacy and safety except for higher puncture rates and access cross-over.

Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization: Systematic review and meta‐analysis

“…MACE was assessed in 4,796 patients and there was no statistically significant difference in the incidence of MACE between patients who received the trans‐ulnar or the trans‐radial approach. Despite the addition of a large RCT that included 2,532 patients to the meta‐analysis, the findings are similar to a previous meta‐analysis performed in 2006 (total five RCTs involving 2,744 patients) that showed similar rates of MACE (RR 0.87, 95% CI 0.56–1.36, P = 0.54) . The results thus demonstrate the non‐inferiority and safety of the trans‐ulnar approach for cardiac catheterization.…”

“…Other studies have reported that the incidence of severe arterial spasm and forearm hematoma among patients who had the trans‐ulnar approach was significantly less than those who had the trans‐radial approach. Results of a meta‐analysis that included five RCTs involving 2,744 total patients reported similar risks of MACE [RR 0.87; 95% CI 0.56–1.36] and access‐related complications [RR 0.92 (0.67–1.27); P = 0.62] in patients having trans‐ulnar and trans‐radial cardiac catheterization. However, the trans‐ulnar approach had higher rates of access site cross‐over [RR 2.31 (1.07–4.98); P = 0.003] and number of punctures [1.57 vs. 1.4; mean difference (MD): 0.17; 95% CI 0.08–0.26; P = 0.0002] compared to the trans‐radial approach.…”

Complicações do acesso vascular em pacientes submetidos a procedimentos percutâneos em hemodinâmica: revisão de escopo

“…With regard to the risk of complications associated with this access, similar results were found when comparing ulnar access with radial access (11) . However, brachial artery access, although little used by some specialties, is an option in peripheral vascular procedures and an alternative access in case of failure of other routes.…”

“…Ulnar access proved to be a safe and effective option in case of failure of the ipsilateral radial route (37) . A recent meta-analysis reported that similar results were found when comparing ulnar access with radial access, with regard to risk of complications associated with the access (11) . Regarding complications according to access routes, ecchymosis is characterized as the most frequent complication for both femoral and radial access routes.…”

Transulnar cardiac catheterization and percutaneous coronary intervention: techniques, transradial comparisons, anatomical considerations, and comprehensive literature review

“…In a meta‐analysis of 5 randomized controlled trials of ulnar versus radial coronary angiography or PCI for STEMI, NSTEMI, and unstable angina (2744 patients; 1384 ulnar and 1360 radial), ulnar had similar efficacy and safety compared with radial in a follow‐up of 1 to 12 months. However, ulnar had higher punctures rates before successful vessel cannulation and increased access site crossover . Unfortunately, all the studies of the meta‐analysis were not equally matched and adequately powered for definitive conclusions.…”