Skip to Main content Skip to Navigation
Master Thesis

Abord ulnaire homolatéral : alternative en cas de défaut de la voie radiale

Abstract : Introduction: Transradial approach reduces bleeding complications and improves patient comfort, that’s why it’s widely used compared to transfemoral in coronary angiography. However, radial artery occlusion limits the ability for repeat catheterization. Hand’s vascularization is rich and complex which allows the use of transulnar catheterization. The aim of this study is to analyze feasibility and safety of transulnar approach when ipsilateral radial access is not available. Methods: 98 transulnar catheterization and/or percutaneous coronary intervention were collected retrospectively from 90 patients between January 2012 and June 2015 in Bordeaux’s Cardiology intensive care. Those data were compared to 1270 transradial and transhumeral coronary angiography. Clinical information, procedural data and success rate were collected. Results: We successfully performed 95 ulnar catheterizations and 1250 radial/humeral catheterizations, 97% and 98.4% respectively (p=0.86). There is no difference between the groups in regards to fluoroscopy time (11.5 vs 12 min, p=0.61), radiation level (86 vs 79 mGy/cm², p = 0.88) or in contrast volume (140 vs 150 mL, p = 0.85). With the transulnar approach, there was 3% of complications (1 minor hematoma, 1 asymptomatic dissection and 1 ulnar thrombosis with acute hand ischemia treated with angioplasty). No ulnar spasm or ulnar nerve injury occurred. Conclusion: Transulnar approach is a complex but safe and feasible alternative wrist access when performed by experienced radial operators, providing high success rate and low incidence of vascular access-site complications. It must be reserved to stable indications but extensive studies are still needed.
Document type :
Master Thesis
Complete list of metadata

Cited literature [97 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01246230
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, December 18, 2015 - 11:45:27 AM
Last modification on : Wednesday, August 23, 2017 - 4:32:45 PM
Long-term archiving on: : Saturday, March 19, 2016 - 12:20:50 PM

Identifiers

  • HAL Id : dumas-01246230, version 1

Collections

Citation

Aurore Flacher. Abord ulnaire homolatéral : alternative en cas de défaut de la voie radiale. Médecine humaine et pathologie. 2015. ⟨dumas-01246230⟩

Share

Metrics

Record views

119

Files downloads

590