title: Feasibility of the radial artery as a vascular access route in performing primary percutaneous coronary intervention.
abstract: We aimed to evaluate the feasibility of transradial primary percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI) by comparing the procedural results and complications with those of transfemoral intervention. From April 1997 to October 2004, we enrolled 352 consecutive cases of STEMI who underwent primary PCI. The femoral route was used in 132 cases (TFI group) and the radial route was used in 220 cases (TRI group). Cases with Killips class IV, a negative Allen test or a non-palpable radial artery were excluded from our study. Baseline clinical and angiographic profiles were comparable in both groups. Vascular access time was 3.8 +/- 3.5 min in the TFI group and 3.6 +/- 3.1 min in the TRI group, and cath room to reperfusion time was 25 +/- 11 min in the TRI group and 26 +/- 13 min in the TRI group. The procedural success rate was 89% in the TFI group and 88% in the TRI group. Crossover occurred in 9 cases (4%) due to approaching vessel tortuosity in the TRI group. Major access site complications occurred in 7 cases (5%) in the TFI group, and there were no complications in the TRI group (p < 0.001). Although radial occlusion occurred in 5 cases of the TRI group, there was no evidence of hand ischemia. The total hospital stay was significantly shorter in TRI group than in TFI group. In conclusion, use of the radial artery might be a potential vascular access route in performing primary PCI in selected cases.
authors.affiliation: Department of Cardiology, Wonju College of Medicine, Yonsei University, 162 Ilsan-dong, Wonju 220-701, Korea.
authors.forename: Jang Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Jung
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Ko
authors.forename: Byung Su
authors.initials: BS
authors.lastname: Yoo
authors.forename: Sung Oh
authors.initials: SO
authors.lastname: Hwang
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Choe
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D017534:Radial Artery; D012189:Retrospective Studies