Distal Radial and Ulnar Arteries: the Alternative Forearm Access

Analkumar Parikh, Kelly Q. Jia, Sumeet K. Lall, Ravi S. Shah, Ian C. Gilchrist

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Purpose of review: Radial artery access for catheter-based procedures has demonstrated improved margins of safety and patient comfort without a loss of efficacy compared with femoral access. Unfortunately, radial access is not always available, so a review of the alternatives such as the ulnar artery and distal radial artery has been completed to understand alternative access sites that may preserve the benefits of distal forearm access without losing the efficacy of traditional transradial access. Recent findings: Several different trials have demonstrated the utility of ulnar access as a possible workhorse access point. These suggest efficacy and safety, but inferior ease-of-access and more crossover than traditional radial access exists. Distal (dorsal) radial access has also been shown to have reasonable efficacy and offer some ergonomic advantages, but this comes at the price that 20–30% of all comers may not have a sufficiently large artery to use. Summary: Understanding the anatomy and techniques required to access the non-traditional, distal forearm arteries increases the skill set of operators. While neither the ulnar nor distal radial appears to substitute completely for radial access, both have potential applications that should be considered, and their utility should not be ignored.

Original languageEnglish (US)
Article number1
JournalCurrent Treatment Options in Cardiovascular Medicine
Issue number1
StatePublished - Jan 1 2020

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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