Coronary angiogram and intervention through transulnar approach.

BACKGROUND: This study was conducted to assess the safety and feasibility of a transulnar approach in performing diagnostic and interventional percutaneous coronary procedures. METHODS AND RESULTS: In the year 2004, a total of 100 patients underwent diagnostic angiography (n=64) and percutaneous coronary interventions (n=36) through transulnar approach. The patients' age ranged from 40 to 70 years and male to female ratio was 7.3:1. The cases of percutaneous coronary interventions were mostly elective procedures and emergency intervention was done in only 2 patients. The procedure was successful in 95 (95%) patients and unsuccessful in 5 (4 diagnostic and 1 percutaneous coronary intervention). The procedure was done through right ulnar artery in all except one patient in whom it was done through left ulnar artery. The total procedure time ranged between 25-45 min. Among the cases of percutaneous coronary interventions, single vessel angioplasty was performed in 23 (65.7%) patients, double vessel in 11 (31.4%) patients and triple vessel in 1 (3%) patient. All percutaneous coronary intervention patients received aspirin, clopidogrel and intravenous enoxaparin. Glycoprotein IIb/IIIa inhibitors were used in 7 patients. Complications such as local hematoma, ulnar artery perforation and reversible parasthesia occurred in one patient each. CONCLUSIONS: Tansulnar approach is a safe and easy alternative technique to perform diagnostic and therapeutic coronary interventions.

Sports-related lesions of the pubic symphysis

Osteitis pubis is a general term, which has been used in the literature for various types of lesions with or without any evidence of infection. We assessed 12 cases of pubic pain in sportsmen. The pubic uptake of technetium 99 MDP in these cases was found to be of doubtful value. Radiographic findings varied from just sclerosis to fragmentation and irregularity at the symphysis pubis. Our observation revealed that this is a self-limiting disease. It is invariably a traumatic lesion and should be called stress symphysitis of the pubis, and must be distinguished from purely infective lesions, e.g. pyogenic osteitis pubis