[Transradial approach for percutaneous coronary stenting in the treatment of acute myocardial infarction].
OBJECTIVE
Treatment of acute myocardial infarction by percutaneous coronary intervention with stenting leads to excellent immediate clinical results and a good prognosis. The aim of this study was to compare in this selected population the safety and effectiveness of radial artery access versus femoral artery access.


METHODS
Between May 2001 and June 2003, 162 consecutive patients with acute myocardial infarction < 12 hours treated by percutaneous stenting were included in an observational study. The radial artery approach was used in 103 patients, and the femoral artery approach in the remaining 59 patients. The success of the procedure, incidence of major adverse cardiac events and local puncture complications were compared in patients treated with the radial artery versus the femoral artery approach.


RESULTS
Fluoroscopy time (22.4 [15.4] min vs 24.5 [19.5] min), immediate success of the procedure (96.1% vs 94.9%), and the incidence of major adverse cardiac events (6.8% vs 8.5%) did not differ between the two groups. Bleeding complications due to local puncture were present only in the femoral artery access group (0 vs 5 patients; P= .007).


CONCLUSIONS
In selected patients with acute myocardial infarction treated with primary stent implantation, the success rate and clinical safety of the radial artery approach are similar to those of the femoral artery approach, but the incidence of local complications, especially bleeding, is significantly lower in the former. Thus the radial artery approach should become the approach of choice in patients at high risk for bleeding complications.
Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital General Universitario Virgen del Rocío, Sevilla, Spain. luissalvadordiaz@hotmail.com
Luis S
LS
Díaz de la Llera
Juan A
JA
Fournier Andray
Silvia
S
Gómez Moreno
Eduardo
E
Arana Rueda
Mónica
M
Fernández Quero
José A
JA
Pérez Fernández-Cortacero
Sara
S
Ballesteros Prada
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017534:Radial Artery / Q000601:surgery*; D016896:Treatment Outcome