Early Ulnar Artery Occlusion and Recanalization After Coronary Angiography via Distal Ulnar Access: A Doppler-Followed Case Series.

Abstract

This single-center retrospective case series assessed early ulnar artery patency by Doppler ultrasonography (DUS) after coronary angiography via distal ulnar access (DUA), described flow evolution in patients with follow-up, and reported access-related complications. Thirty-eight consecutive patients with a day-3 DUS after coronary angiography via DUA between September 2023 and March 2024 were included. All procedures were performed by 1 operator using a short 6F sheath and 5000 IU intra-arterial heparin. Flow was categorized as thrombosis/no flow, monophasic, or triphasic; the primary endpoint was day-3 non-triphasic flow, and month-1 and month-3 DUS were selective. Mean age was 58.8 ± 10.1 years and 47.4% were male; 21.1% underwent same-session percutaneous coronary intervention. On day 3, thrombosis/no flow occurred in 18.4% (7/38), monophasic flow in 5.3% (2/38), and triphasic flow in 76.3% (29/38); non-triphasic flow was 23.7% (9/38). Month-1 DUS (n = 35) showed no thrombosis/no flow and 94.3% triphasic flow; month-3 DUS (n = 4) was triphasic in all. No clinically relevant hematoma, neuropathy, hand ischemia, or functional impairment was documented. After coronary angiography via DUA, day-3 non-triphasic flow occurred in 23.7%; selective follow-up suggested recanalization without major clinical complications, but limits generalizability.