Feasibility of Coronary Angiography via Ulnar Artery with Ipsilateral Radial Artery Occlusion and Type-D Barbeau Test Response

Radial artery is the recommended access site for coronary angiography. Ulnar artery can be an alternative route, but safety concerns in case of ipsilateral radial artery occlusion exist. We successfully performed ulnar artery cannulation and coronary angiography in a 75-year-old man with obstructive peripheral artery disease, despite chronic radial artery occlusion and a type-D Barbeau test response, giving an example on the feasibility of this procedure. Further investigation is needed to prove the safety of ulnar artery puncture in the whole spectrum of the Barbeau test.