{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:15:05Z","timestamp":1783041305660,"version":"3.54.6"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Transradial access (TRA) is used with a Class IA recommendation for coronary angiography (CA) or percutaneous coronary intervention (PCI). Difficult vascular anatomy (DVA) of the forearm arteries is a challenge to its success. Transulnar artery access (TUA) may constitute a viable alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center study, we retrospectively compared the prevalence of DVA at the forearm arteries in 2565 consecutive cases of CA\/PCI (2403 TRA and 162 TUA) between 2019 and 2022. DVA was classified as zeroth\u2010degree if the forearm could be passed with a standard 0.035\u2033 guidewire. First\u2010degree was defined if a standard 0.035\u2033 guidewire had to be switched to a hydrophilic 0.035\u2033 or a 0.018\u2033 guidewire to successfully reach the brachial artery and second\u2010degree DVA if the forearm arteries could not be passed with any guidewire leading to procedural failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, DVA was significantly more prevalent in TRA versus TUA (zeroth\u2010degree, first\u2010degree, second\u2010degree: 90.3%, 7.2%, and 2.5% vs. 96.9%, 3.1%, and 0%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). After 4:1 propensity score matching, second\u2010degree DVA remained more prevalent in TRA versus TUA (2.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009648) vs. 0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009162,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In our retrospective analysis, primary TUA was found to be superior to TRA regarding DVA at the forearm arteries. TUA may present a superior alternative to TRA for CA\/PCI in the era of ultrasound\u2010guided arterial access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71037","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T05:20:36Z","timestamp":1752211236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Prevalence of Difficult Vascular Anatomy in Transulnar Versus Transradial Access for Cardiac Catheterization in Propensity Score\u2010Matched Cohorts"],"prefix":"10.1002","volume":"8","author":[{"given":"Mona Maria","family":"Grewe","sequence":"first","affiliation":[{"name":"Clinic of Cardiology and Angiology, Klinikum Neumarkt Neumarkt in der Oberpfalz Germany"},{"name":"Department of Internal Medicine II University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3506-6750","authenticated-orcid":false,"given":"Franziska","family":"Fochler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9209-040X","authenticated-orcid":false,"given":"Peter Hubert","family":"Grewe","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Angiology, Klinikum Neumarkt Neumarkt in der Oberpfalz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Angiology, Klinikum Neumarkt Neumarkt in der Oberpfalz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstin","family":"Meier","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Angiology, Klinikum Neumarkt Neumarkt in der Oberpfalz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Roeschl","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Angiology, Klinikum Neumarkt Neumarkt in der Oberpfalz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"issue":"4","key":"e_1_2_13_3_1","article-title":"Transradial Versus Transfemoral Approach for Diagnostic Coronary Angiography and Percutaneous Coronary Intervention in People With Coronary Artery Disease","volume":"4","author":"Kolkailah A. 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