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Efficacy and safety of transulnar coronary angiography and interventions—A single center experience

Authors

  • Anand R. Deshmukh MD,

    Corresponding author
    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
    • Correspondence to: Anand R. Deshmukh, Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, 3006 Webster Street, Omaha, NE. E-mail: dranandrdeshmukh@gmail.com

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  • Manu Kaushik MD,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Ahmed Aboeata MBBCH,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Jamil Abuzetun MD,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Tammy L. Burns PHARMD,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Caroline A. Nubel BS,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Michael D. White MD, FACC,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Thomas J. Lanspa MD, FACC,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Claire B. Hunter MD, FACC,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Aryan N. Mooss MD, FACC,

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Dennis J. Esterbrooks MD, FACC

    1. Division of Cardiovascular Medicine, Department Internal Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska
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  • Conflict of interest: Nothing to report.

Abstract

Objectives

To evaluate the efficacy and long-term safety of transulnar approach in complex coronary interventions.

Background

The success rate of transulnar approach in complex coronary interventions and its long-term safety remains to be proven.

Methods

We conducted a retrospective chart review of patients undergoing transulnar coronary angiography and interventions at our institution from January 2004 through July 2009. Primary endpoint of the study was the success rate of the procedure. Secondary endpoints were major bleeding, local vascular and neurological complications, cerebrovascular accident (CVA)/transient ischemic attack (TIA), myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE) rate that was a composite of MI, CVA/TIA, and all-cause mortality.

Results

Of 81 patients undergoing transulnar approach, 41 (50.6%) patients underwent intervention on 65 lesions. Twelve percent of the interventions were performed on coronary bypass grafts and 9.2% on the left main coronary artery. Success rates for transulnar access, coronary angiography, and coronary/bypass graft interventions were 93.8%, 100%, and 92.6%, respectively. Follow-up data was available on 71 patients at short term (30 days) and 58 patients at long term (1 year). At 30-day follow-up, vascular complication rate was 2.8 %. At 1-year follow-up, there were no residual deficits from vascular or neurological complications associated with the index procedure and the overall MACE rate was 3.4%.

Conclusion

In this first study evaluating long-term safety and feasibility of transulnar coronary angiography and complex coronary interventions, we conclude that transulnar approach appears to be safe and effective. © 2013 Wiley Periodicals, Inc.

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