Aoi Shunsuke, Gonzalez Carlos, Chan Doris, Kwan Tak
Department of Cardiology, Mount Sinai Beth Israel, 16th Street and 1st Avenue, New York, NY 10003, USA.
Department of Cardiology, Mount Sinai Beth Israel, 16th Street and 1st Avenue, New York, NY 10003, USA.
Cardiovasc Revasc Med. 2021 Jan;22:84-88. doi: 10.1016/j.carrev.2020.06.018. Epub 2020 Jun 20.
This study investigated the feasibility and safety of transulnar access (TUA) and efficacy of novel TR band modification for dual site hemostasis in patients with failed ipsilateral transradial approach.
Failed transradial access requires cross over to alternative access site. There is paucity of data on feasibility and safety of ipsilateral TUA due to concern of potential risk of hand ischemia.
We retrospectively reviewed ten patients who underwent coronary angiography and intervention via ulnar artery in the setting of failed ipsilateral transradial access. Patent hemostasis for both ulnar and radial arteries was achieved with novel modification of the TR band to compress both arteries at the same level of puncture sites.
TUA after failed ipsilateral transradial access was successful in all ten cases. All patients were followed within 7 days and there were no adverse complications such as ulnar artery occlusion, nerve injury, or hand ischemia.
TUA maybe a safe and viable option when cross over is necessary from failed ipsilateral transradial access. Modification of the TR band for both radial and ulnar access site can achieve patent hemostasis effectively at the level of both puncture sites.
本研究探讨了经尺动脉入路（TUA）在同侧桡动脉入路失败患者中进行双部位止血的可行性、安全性以及新型TR带改良的有效性。
桡动脉入路失败需要转换至其他入路部位。由于担心手部缺血的潜在风险，关于同侧TUA可行性和安全性的数据较少。
我们回顾性分析了10例在同侧桡动脉入路失败后经尺动脉行冠状动脉造影和介入治疗的患者。通过对TR带进行新型改良，在相同穿刺部位水平压迫尺动脉和桡动脉，实现了两动脉的有效止血。
同侧桡动脉入路失败后行TUA的10例患者均成功。所有患者均在7天内接受随访，未出现尺动脉闭塞、神经损伤或手部缺血等不良并发症。
当同侧桡动脉入路失败且需要转换入路时，TUA可能是一种安全可行的选择。对桡动脉和尺动脉入路部位的TR带进行改良，可在两个穿刺部位水平有效实现止血。
