Transulnar Versus Transradial Access in Post-CABG Patients Undergoing Coronary Angiography

Objective: Patients with a history of coronary artery bypass grafting (CABG) often present with advanced age, comorbidities, and diffuse atherosclerosis, making coronary angiography more complex. While the transfemoral route has been traditionally preferred, transradial access has emerged as a safer and more comfortable alternative. Recently, transulnar access has also gained interest, especially when radial access is not feasible. To compare the efficacy and safety of transulnar versus transradial access in CABG patients undergoing coronary angiography.Method: In this retrospective, single-center study, 37 post-CABG patients who underwent coronary angiography between 2022 and 2024 via left radial (n=18) or left ulnar (n=19) access were evaluated. Baseline demographics, risk factors, laboratory data, procedural parameters, and complications were analyzed. All procedures were performed with 6 Fr catheters.Results: The groups were comparable in terms of demographics, risk factors, and laboratory findings. There were no significant differences in procedure time, fluoroscopy duration, radiation dose, or catheter use. However, puncture time was significantly shorter in the transradial group (15.8 ± 8 vs. 28.2 ± 17 min, p=0.007). No major complications occurred in either group. Femoral crossover was more frequent in the transulnar group, though not statistically significant (21.1% vs. 0%, p=0.059).Conclusions: Transulnar access is a safe and effective alternative to transradial Access in CABG patients undergoing coronary angiography. While puncture time was longer in the transulnar group, overall procedural success and safety were comparable. Transulnar access may be especially useful when radial access is limited