eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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4/2020
vol. 16
 
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abstract:
Original paper

TransRadial versus transUlnar artery approach for elective invasive percutaneous coronary interventions: a randomized trial on the feasibility and safety with ultrasonographic outcome – RAUL study

Dagmara Gralak-Lachowska
1
,
Paweł J. Lewandowski
1
,
Pawel Maciejewski
1
,
Bogumił Ramotowski
1
,
Andrzej Budaj
1
,
Sebastian Stec
2

  1. Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
  2. MediNice Research and Development Centre, Rzeszow/Krosno, Poland
Adv Interv Cardiol 2020; 16, 4 (62): 376–383
DOI: https://doi.org/10.5114/aic.2020.101761
Online publish date: 2020/12/29
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Introduction
Transradial access (TRA) for coronary angiography (CAG) and percutaneous coronary intervention (PCI) is superior to transfemoral access (TFA). Transulnar access (TUA) is an alternative to TRA. Aim: To compare the efficacy and safety of TRA vs. TUA in patients scheduled for CAG or PCI.

Material and methods
This was a prospective, single-center, randomized study conducted between 2013 and 2016. Two hundred patients referred for the first elective CAG were included in the study. Eligible patients were then randomly assigned to the TRA or TUA group. Before and after the invasive procedure, all patients underwent ultrasonographic measurements of the right upper limb arteries.

Results
The primary endpoint was efficacy, defined as a successful CAG without a crossover of vascular access. The secondary endpoint was safety, assessed as the number of vascular complications. Successful coronary angiography via the access site was 95% vs. 75% in the TRA vs. TUA groups, respectively (p < 0.001). It depended on the anatomy of UA and the operator experience. No differences were observed in early and late follow-up complications.

Conclusions
TRA was superior to TUA with regard to efficacy. TUA occurred a safe approach for CAG and PCI and could be used as an alternative method of forearm access.

keywords:

transulnar access, complications, ultrasonography
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