Meta-Analysis Suggests Ulnar Artery May Be a Safe Alternative to Radial Artery for Cardiac Catheterization
February 12, 2018—Ritin Fernandez, PhD, et al published meta-analysis data online in Catheterization and Cardiovascular Interventions reviewing six randomized controlled trials evaluating adult patients who had a percutaneous coronary procedure via the radial or ulnar artery. The study aimed to synthesize available evidence on the impact on major adverse cardiac events (MACEs) of ulnar artery compared with radial artery cardiac catheterization.
Investigators searched published and unpublished trials up to May 2017 for the use of ulnar versus radial artery cardiac catheterization. Two reviewers assessed methodologic quality using the Joanna Briggs Institute Meta-analysis of Statistics Assessment and Review Instrument checklist.
As summarized in Catheterization and Cardiovascular Interventions, there was no statistically significant difference in the incidence of MACE between patients who underwent transulnar or transradial artery catheterization (risk ratio [RR], 0.90; 95% confidence interval [CI], 0.66–1.23). Five trials investigated complications associated with access, including hematoma formation, pseudoaneurysm, and arteriovenous fistulae formation, and among 2,744 patients, significantly more complications were reported in the transulnar group (RR, 3.58; 95% CI, 2.67–4.79; P < .00001). No differences in arterial access time, fluoroscopy time, and contrast load were noted between the two groups.
The investigators in Catheterization and Cardiovascular Interventions concluded there is evidence to support the safe use of the ulnar artery as an alternative to radial artery access for cardiac catheterization.