title: Transradial primary angioplasty and stenting in Indian patients with acute myocardial infarction: acute results and 6-month follow-up.
abstract: BACKGROUND
  Coronary angioplasty and stent implantation is effective as primary intervention in acute myocardial infarction. Because of fewer puncture site complications and improved patient comfort, transradial access has been increasingly used as an alternative to transfemoral access for percutaneous coronary interventions.
  
  
  RESULTS
  We studied 103 patients (94 men, 9 women: mean age 52.5 +/- 11.96 years) with a diagnosis of acute myocardial infarction (<12 hours after onset), who underwent primary percutaneous coronary intervention. Transradial access was used in all patients with a normal Allen's test and transfemoral access was used additionally only if intra-aortic balloon counterpulsation was required. Follow-up duration was 6 months. Transradial access was successfully achieved in all patients. Radial artery cannulation took <2 min in more than 85% patients. During percutaneous coronary intervention, cannulation to balloon inflation times and total procedure times were 11.3 +/- 5.2 min and 19.9 +/- 10.8 min, respectively. Stents were implanted in 99 (96.1%) patients andplain balloon angioplastywas performed in 3.9%. The primary success rate was 98.1%, with no major bleeding complications. Total length of hospitalization averaged 2.4 +/- 0.8 days. In-hospital major adverse clinical events rate was 5.9%. Six-month clinical follow-up was achieved for 84 (86.6%) patients. Six (7.1%) patients died during follow-up. Follow-up coronary angiography was performed in 22 (26.2%) patients. After 6 months, 7 patients required revascularizationof the target lesion. The rate of survival without myocardial infarction, bypass surgery or repeat coronary angioplasty was 88.5% at 6 months.
  
  
  CONCLUSIONS
  Transradial access may represent a safe and feasible technique for performing primary percutaneous coronary intervention with good acute results and without major bleeding complications.
authors.affiliation: Department of Cardiovascular Sciences, Sterling Hospital, Ahlmedabad. grayranjan@yahoo.com
authors.forename: Alok
authors.initials: A
authors.lastname: Ranjan
authors.forename: Tejas M
authors.initials: TM
authors.lastname: Patel
authors.forename: Sanjay C
authors.initials: SC
authors.lastname: Shah
authors.forename: Hemant
authors.initials: H
authors.lastname: Malhotra
authors.forename: Rajni
authors.initials: R
authors.lastname: Patel
authors.forename: Nishith
authors.initials: N
authors.lastname: Vayada
authors.forename: Rasesh
authors.initials: R
authors.lastname: Pothiwala
authors.forename: Keith
authors.initials: K
authors.lastname: Fonseca
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Tanwar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017534:Radial Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome