Ulnar artery: The Ulysses ultimate resort for coronary procedures

Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registr...
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Gespeichert in:

Autor*in:	George Hahalis, MD, PhD [verfasserIn] Spyridon Deftereos, MD, PhD [verfasserIn] Olivier F. Bertrand, MD, PhD, FSCAI [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Ulnar artery Radial artery Transulnar Transradial Coronary catheterization Transfemoral approach

Übergeordnetes Werk:	In: Hellenic Journal of Cardiology - Elsevier, 2017, 57(2016), 4, Seite 238-246
Übergeordnetes Werk:	volume:57 ; year:2016 ; number:4 ; pages:238-246

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.hjc.2016.07.006

Katalog-ID:	DOAJ060470569

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allfieldsGer	10.1016/j.hjc.2016.07.006 doi (DE-627)DOAJ060470569 (DE-599)DOAJ07e295bfbb414bd589a5dd7a6d770916 DE-627 ger DE-627 rakwb eng RC666-701 George Hahalis, MD, PhD verfasserin aut Ulnar artery: The Ulysses ultimate resort for coronary procedures 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates. Ulnar artery Radial artery Transulnar Transradial Coronary catheterization Transfemoral approach Diseases of the circulatory (Cardiovascular) system Spyridon Deftereos, MD, PhD verfasserin aut Olivier F. Bertrand, MD, PhD, FSCAI verfasserin aut In Hellenic Journal of Cardiology Elsevier, 2017 57(2016), 4, Seite 238-246 (DE-627)374600511 (DE-600)2128441-6 11099666 nnns volume:57 year:2016 number:4 pages:238-246 https://doi.org/10.1016/j.hjc.2016.07.006 kostenfrei https://doaj.org/article/07e295bfbb414bd589a5dd7a6d770916 kostenfrei http://www.sciencedirect.com/science/article/pii/S1109966616301464 kostenfrei https://doaj.org/toc/1109-9666 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2016 4 238-246
allfieldsSound	10.1016/j.hjc.2016.07.006 doi (DE-627)DOAJ060470569 (DE-599)DOAJ07e295bfbb414bd589a5dd7a6d770916 DE-627 ger DE-627 rakwb eng RC666-701 George Hahalis, MD, PhD verfasserin aut Ulnar artery: The Ulysses ultimate resort for coronary procedures 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates. Ulnar artery Radial artery Transulnar Transradial Coronary catheterization Transfemoral approach Diseases of the circulatory (Cardiovascular) system Spyridon Deftereos, MD, PhD verfasserin aut Olivier F. Bertrand, MD, PhD, FSCAI verfasserin aut In Hellenic Journal of Cardiology Elsevier, 2017 57(2016), 4, Seite 238-246 (DE-627)374600511 (DE-600)2128441-6 11099666 nnns volume:57 year:2016 number:4 pages:238-246 https://doi.org/10.1016/j.hjc.2016.07.006 kostenfrei https://doaj.org/article/07e295bfbb414bd589a5dd7a6d770916 kostenfrei http://www.sciencedirect.com/science/article/pii/S1109966616301464 kostenfrei https://doaj.org/toc/1109-9666 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2016 4 238-246
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source	In Hellenic Journal of Cardiology 57(2016), 4, Seite 238-246 volume:57 year:2016 number:4 pages:238-246
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topic_facet	Ulnar artery Radial artery Transulnar Transradial Coronary catheterization Transfemoral approach Diseases of the circulatory (Cardiovascular) system
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callnumber-first	R - Medicine
author	George Hahalis, MD, PhD
spellingShingle	George Hahalis, MD, PhD misc RC666-701 misc Ulnar artery misc Radial artery misc Transulnar misc Transradial misc Coronary catheterization misc Transfemoral approach misc Diseases of the circulatory (Cardiovascular) system Ulnar artery: The Ulysses ultimate resort for coronary procedures
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topic_title	RC666-701 Ulnar artery: The Ulysses ultimate resort for coronary procedures Ulnar artery Radial artery Transulnar Transradial Coronary catheterization Transfemoral approach
topic	misc RC666-701 misc Ulnar artery misc Radial artery misc Transulnar misc Transradial misc Coronary catheterization misc Transfemoral approach misc Diseases of the circulatory (Cardiovascular) system
topic_unstemmed	misc RC666-701 misc Ulnar artery misc Radial artery misc Transulnar misc Transradial misc Coronary catheterization misc Transfemoral approach misc Diseases of the circulatory (Cardiovascular) system
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title	Ulnar artery: The Ulysses ultimate resort for coronary procedures
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title_full	Ulnar artery: The Ulysses ultimate resort for coronary procedures
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title_sort	ulnar artery: the ulysses ultimate resort for coronary procedures
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title_auth	Ulnar artery: The Ulysses ultimate resort for coronary procedures
abstract	Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates.
abstractGer	Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates.
abstract_unstemmed	Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA). Once arterial access is obtained, the likelihood of a successful coronary procedure is high and similar between the two forearm arteries. The UA has similar flow-mediating vasodilating properties with and seems at least as vulnerable as the RA with regard to incident occlusion, with UA occlusion (UAO) rates being probably higher than previously anticipated. A learning curve effect may not be apparent for crossover rates among experienced radialists, but increasing experience is associated with reduction in the fluoroscopy time, contrast volume and frequency of large hematoma formation. The UA may represents an important alternative access site for coronary procedures, and experienced radial operators should obtain additional skills to perform the transulnar approach. Nevertheless, in view of this method's lower feasibility compared to the RA, an initial ulnar access strategy should be reserved for carefully selected patients to ensure satisfactory cannulation rates.
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title_short	Ulnar artery: The Ulysses ultimate resort for coronary procedures
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