Percutaneous Trans-Superficial Palmar Artery Approach (Distal Ulnar) for Coronary Angiography and Angioplasty, a Preliminary Experience at Two Egyptian Cardiology Centers

Abstract

Objectives: To evaluate the feasibility, safety, and reliability of the distal ulnar (superficial palmar) artery approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in comparison to the conventional transradial approach. Methodology: This prospective, randomized clinical study included 90 patients undergoing CAG or PCI at two Egyptian cardiology centers. Patients were randomly assigned to the distal ulnar group (n=45) or the radial group (n=45). Results: The two groups showed no significant differences in baseline characteristics. Sheath insertion time was longer in the distal ulnar group (P<0.001), but compression time and hospital stay were significantly shorter (P<0.001). No significant differences were found in procedure time (P=0.28), antegrade flow (P=0.39), or vascular complications (P=0.57). Duplex ultrasound at follow-up showed no significant differences in arterial patency (P=0.46). Conclusion: The distal ulnar approach is a safe, feasible, and viable alternative to the radial approach for CAG and PCI, offering reduced compression time and hospital stay despite a longer sheath insertion time.