Well-palpable pulse over an occluded radial artery: A case series reporting ultrasound outcomes

We report a case series of four patients with radial artery occlusion complicating vascular access who were scheduled for coronary angiography. We describe the challenges in selecting adequate vascular access in patients with a history of coronary angiography and percutaneous coronary intervention, as well as the benefits of using preprocedural ultrasound examination of forearm arteries to detect radial artery occlusion. Our case series suggests that if the anterior interosseous artery provides partial blood supply to the hand as a collateral circulation of the occluded radial artery, the transulnar approach may be an alternative safe option for coronary angiography and percutaneous coronary intervention in this population.

Automated summary

We present a case series of four patients with radial artery occlusion who were scheduled for coronary angiography. We discuss the challenges of finding suitable vascular access in patients with a history of coronary angiography and percutaneous coronary intervention and highlight the benefits of using preprocedural ultrasound examination to detect radial artery occlusion. Our findings suggest that the transulnar approach could be a safe alternative for these patients if the anterior interosseous artery provides collateral circulation to the hand.