Is the Complication Rate of Ulnar and Radial Approaches for Coronary Artery Intervention the Same?

We compared the clinical outcomes of patients who underwent coronary artery intervention by the transulnar and transradial artery approaches. In this 1 year, single-center study, patients were randomized to either a radial artery (RA) or ulnar artery (UA) group. Of 538 patients, the primary outcome, arterial occlusion of a forearm artery, occurred in 21 of 225 patients in the RA group compared to 6 of 220 patients in the UA group (9.3% vs 2.7%, P = .007). The rate of arterial occlusion was significantly lower following ulnar access compared to radial (odds ratio [OR] = 3.85, P = .006). A higher risk of occlusion was associated with repeated procedures rather than a single procedure (OR = 5.14, P = .003), smoking (OR = 2.39, P = .04), and arterial to sheath diameter ratio of 1 (OR = 2.62, P = .03). However, the disadvantage of UA was an increase of incidence of hematomas (13.2% vs 5.8%, P = .01) and symptoms of discomfort (15.5% vs 5.8%, P = .002). In conclusion, the transulnar strategy proved to be noninferior to the transradial approach for coronary procedures (ClinicalTrials.gov Identifier: NCT01979627).