Background: Primary aim of our study to evaluate the safety and feasibility of percutaneous Trans- Ulnar approach for coronary angiogram and intervention.Methods: Patient whom radial pulse was very feeble and difficult to cannulate and having very good volume Ulnar pulse were selected in this study. Total 48(Male 37: Female 11) patients were enrolled in this very preliminary study who underwent elective coronary angiogram (CAG) and subsequent adhoc percutaneous coronary intervention (PCI) in same sitting. Total 11 stents were deployed in 10 territories. Mean ages of male and female were 59 and 52 years respectively. Associated coronary artery artery disease (CAD) risk factors were dyslipidemia, high blood pressure, diabetes mellitus, positive family history of CAD and smoking (all male).Results: Among the study group; 36(75%) were Dyslipidemic, 35(73%) were hypertensive; 34(70.1%) patients were Diabetic, FH 11(23%), and 12(25%) were all male smoker.PCI performed in 9 patients i.e., 18.8% of the total population of this study. Angiographic diagnosis of TVD 8(16.6%), DVD 6(25%), SVD 17 (35.4%), Normal Coronaries 8(16.6%), ISR or patent stent 5(10.4%), Severe Calcified disease 4(12%). Common stented territory was LAD 6(66%), LCX 2(22%) and RCA 2 (22%). Vaso-spasm was not noted as it is quite often in trans-radial approach. Procedural complication like hematoma was not present.Conclusion: We conclude that trans-ulnar approach is a safe, feasible and effective alternative to Transfemoral and Trans-radial approach, specially due to sluggish flow or feeble radial pulsation with severe spasm of radial artery for coronary angiogram and subsequent PCI.Cardiovasc. j. 2018; 11(1): 5-9

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DOI: http://dx.doi.org/10.3329/pulse.v4i1.6963Pulse Vol.4 January 2010 p.32-33

Introduction:Primary Percutaneous coronary intervention (pPCI) is considered to be superior to thrombolytic treatment for ST elevation acute myocardial infarction (STEMI) especially, in a hospital with angioplasty facilities. [1][2][3] It has been established by several investigators that the achievement of useful means of successful reperfusion was superior in pPCI than compared with thrombolytic therapy. 4-5 Door to balloon time, 6-7 is an important key factor in the success of pPCI. Many have demonstrated that patients, who had pPCI within 2 hrs of symptoms onset had lower mortality and greater myocardial salvage after pPCI and higher rates of complete reperfusion. 8 Aim of our study was to evaluate safety and the survival out come and benefits of pPCI in our hospital. Patient Population:Patients were randomized from the cases who presented to our ED with the onset of chest pain outside hospital of any age for at least 30 minutes but less than 12hrs in duration. ECG criteria were associated with ST elevation at least 0.1mV in 2 or more ECG leads who underwent pPCI at this hospital. Prior to pPCI, informed written consent were taken from the patient or guardians. Methods:Patients were treated with the loading doses of 300mg Aspirin and 600mg Clopidegrol in hospital emergency. With Diagnostic Coronary angiography was done before Percutaneous Coronary Intervention (PCI) to locate culprit infarct related territory or artery. After thrombus suction from the occluded site by a thrombuster sucker if

Background: Aim of our present study was to evaluate the extent of Renal Artery Stenosis(RAS) in patients with Coronary Artery disease (CAD) in context of Bangladesh demographic distribution. Methods: Total 100 patients with renal artery disease were randomized from a pool of 1200 patients who were underwent routine diagnostic coronary angiogram for the evaluation of extent of their CAD. Renal arteries were studied at the same time. Among the patients, Male: 64 and Female: 36. Mean age were for Male: 62yrs, for Female: 58 yrs. Associated CAD risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive FH for CAD and Smoking. Results: Our study results show 100 patients (12% of the sample) had RAS lesion out of total 1200 patient who underwent routine CAG. Sex distribution is male 64 (64%), Female 36 (36%). Among the study group; 79 (79%) were hypertensive; 57 (57%) were Dyslipidemic, 54 (54%) patients were Diabetic, 27 (27%) were smoker (all male) and 18(18%) were having positive FH for CAD. Female patients were more obese and developed CAD in advanced age (male: 53.5 Versus Female:64 yrs). We found that the Prevalence’s of RAS is more in patients with TVD (43%), followed by DVD (10%) and SVD (10%), Minor to mod CAD (14%) and angiographically normal coronaries (23%). Significant (>50% Stenosis) Left renal artery stenosis were found in 27 patient and 23 had significant Right renal artery stenosis. Total 8 patents had significant both renal artery stenosis. Conclusion: Renal artery stenosis is one of the most important peripheral vascular disease, needing to be diagnosed early and subsequent intervention to keep continuity of renal blood flow. In the present study, we found that the significant association of Renal Artery Stenosis in patients with CAD. Incidence of RAS is more in patients with TVD. Therefore, we recommend routine Renal angiogram during coronary angiography. Keywords: Renal artery stenosis; Coronary Artery Disease  DOI: 10.3329/cardio.v2i2.6636Cardiovasc. j. 2010; 2(2) : 179-183