Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography
(1) Background: We aimed to assess the impact of the selection of a larger radial or ulnar artery on the efficacy of access and vascular complications, based on preprocedural ultrasonographic examination. (2) Methods: This prospective, randomized trial included patients undergoing coronary angiograp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/11/3607 |
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| author | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj |
| author_facet | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj |
| author_sort | Pawel Lewandowski |
| collection | DOAJ |
| description | (1) Background: We aimed to assess the impact of the selection of a larger radial or ulnar artery on the efficacy of access and vascular complications, based on preprocedural ultrasonographic examination. (2) Methods: This prospective, randomized trial included patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients were randomized into either a larger ulnar artery (UA) or radial artery (RA) group or smaller UA/RA group. The primary endpoint was successful CAG/PCI without crossover to another artery. The secondary endpoints were incidences of radial or ulnar artery occlusion (RAO/UAO) at the 24 h and 30 day follow-up. (3) Results: Between 2017 and 2018, 200 patients (107 men, mean age 68 ± 8 years) were enrolled. The success of CAG/PCI via the access site was 98% and 83% (<i>p</i> < 0.001) in the larger UA/RA group and smaller UA/RA group, respectively. The independent factor for CAG/PCI success was the larger artery (OR 9.8, 95%CI 2.11–45.5; <i>p</i> < 0.005). The larger UA/RA was superior, with RAO/UAO at 24 h: OR 0.07, 95%CI 0.09–0.61; <i>p</i> < 0.016; and RAO/UAO at 30 days: OR 0.25, 95%CI 0.05–0.12; <i>p</i> < 0.001. (4) Conclusions: Larger artery access was shown to be more efficient and safer than recessive forearm artery access. |
| first_indexed | 2024-03-10T15:00:02Z |
| format | Article |
| id | doaj.art-9f90ac58db974a24998e7520a89cf275 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:00:02Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9f90ac58db974a24998e7520a89cf2752023-11-20T20:18:35ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01911360710.3390/jcm9113607Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural UltrasonographyPawel Lewandowski0Anna Zuk1Tomasz Slomski2Pawel Maciejewski3Bogumil Ramotowski4Andrzej Budaj5Cardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, PolandCardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, PolandCardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, PolandCardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, PolandCardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, PolandCardiology Department, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, Poland(1) Background: We aimed to assess the impact of the selection of a larger radial or ulnar artery on the efficacy of access and vascular complications, based on preprocedural ultrasonographic examination. (2) Methods: This prospective, randomized trial included patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients were randomized into either a larger ulnar artery (UA) or radial artery (RA) group or smaller UA/RA group. The primary endpoint was successful CAG/PCI without crossover to another artery. The secondary endpoints were incidences of radial or ulnar artery occlusion (RAO/UAO) at the 24 h and 30 day follow-up. (3) Results: Between 2017 and 2018, 200 patients (107 men, mean age 68 ± 8 years) were enrolled. The success of CAG/PCI via the access site was 98% and 83% (<i>p</i> < 0.001) in the larger UA/RA group and smaller UA/RA group, respectively. The independent factor for CAG/PCI success was the larger artery (OR 9.8, 95%CI 2.11–45.5; <i>p</i> < 0.005). The larger UA/RA was superior, with RAO/UAO at 24 h: OR 0.07, 95%CI 0.09–0.61; <i>p</i> < 0.016; and RAO/UAO at 30 days: OR 0.25, 95%CI 0.05–0.12; <i>p</i> < 0.001. (4) Conclusions: Larger artery access was shown to be more efficient and safer than recessive forearm artery access.https://www.mdpi.com/2077-0383/9/11/3607transradial accesstransulnar accesscomplicationsultrasound examination |
| spellingShingle | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography Journal of Clinical Medicine transradial access transulnar access complications ultrasound examination |
| title | Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography |
| title_full | Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography |
| title_fullStr | Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography |
| title_full_unstemmed | Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography |
| title_short | Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography |
| title_sort | impact of the use of a larger forearm artery on the efficacy and safety of transradial and transulnar access a randomized trial with preprocedural ultrasonography |
| topic | transradial access transulnar access complications ultrasound examination |
| url | https://www.mdpi.com/2077-0383/9/11/3607 |
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