e0641 Contrast study of transulnar artery PCI and transradial artery PCI

Abstract

Introduction: The diameter in ulnar artery is similar to that in radial artery, but the ulnar artery approach as alternative of forearm access for PCI has still been a few application. This study was to compare the feasibility and safety of TUA-PCI vs. TRA-PCI (transradial artery PCI). Methods: 320 patients from 38 to 80 years old were randomized into transradial artery PCI group (male 131, female 29) and transulnar artery group (male 133, female 27). The time of manipulative duration for each procedure of PCI was recorded. The time of Allen's test, lumen diameter (mm), cross area of vessel lumen (mm 2), blood velocity (Vs max), blood flow resistance index (RI) in ulnar and radial artery were measured and recorded, respectively, as well were compared quantitatively before and after PCI procedure. Result: In each group the success rate of puncture of access artery was 98.7%, because each group had 2 cases failed and transferred to another group. In PCI-TRU group 212 lesion segments of 178 vessels in all patients were angioplasticized successfully via TRU by 6F guiding catheter and 215 stents were implanted. The average time of manipulative duration of guiding catheters engaging in ostium of target coronary artery, the average time of under X ray fluoroscopy and the total time of the whole procedure were no significant difference between the PCI-TRU group and the PCI-TRA group 4.25+/-0.56 vs 4.22+/-0.49 min, 23.8+/-0.46 vs 22.9+/-0.57 min and, 54.6+/-12.4 vs 52.8+/-14.2 min respectively. In PCI-TRA group 210 lesion segments of 177 vessels in were angioplasticized successfully via TRA by 6F guiding catheter and 214 stents were implanted. When the introducer was taken off, with maintaining heparin infusion immediately after procedure, the access site in ulnar or radial artery was compressed by a tourniquet for 6 hours and the compress pressure were gradually decreased, and it was unnecessary to limit the ambulance of the patients. The average hospital stay was no statistic significance between PCI-TRU group and PCI-TRA group (5.22+/-0.41 days vs 5.31 +/-0.37 days), P>0.05. No significant change was found in the parameters of the vessel diameter, blood velocity, cross area of vessel lumen, blood flow resistance index and the level of blood oxygen in finger and no complication such as occlusion of ulnar or radial artery in all patients following up 1 month after PCI procedure.. Conclusion: Transulnar artery PCI was as safety and efficacy as transradial artery, the ulnar artery might be selested as one approach of antebrachial artery for PCI in patients with coronary heart disease.