Reduced vascular complications and length of stay with transradial rescue angioplasty for acute myocardial infarction.
OBJECTIVE
The aim of this study was to compare clinical outcomes for transradial and transfemoral percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction undergoing rescue angioplasty.


BACKGROUND
Transfemoral percutaneous coronary intervention in patients with acute myocardial infarction treated with systemic thrombolysis is associated with a significant risk of vascular complications. A transradial approach may reduce vascular complications, improve mobilization and facilitate earlier discharge.


METHODS
In a retrospective analysis, clinical outcomes for 287 consecutive patients undergoing rescue angioplasty for acute myocardial infarction were determined. Data were recorded using a standardized proforma and analyzed using SPSS.


RESULTS
Procedural success was similar for the transradial and transfemoral routes (98% vs. 93%; P = 0.3). There was a reduction in vascular complications (0 (0%) vs. 32 (13%); P < 0.01) and post-procedural length of stay (7.0 +/- 7.9 vs. 7.9 +/- 5.6 days; P < 0.005) in the radial group when compared with the femoral group. There were no differences in procedural or in-hospital mortality, procedure duration, or radiation dose between the two groups.


CONCLUSIONS
Rescue angioplasty performed via the radial artery is safe, effective, and associated with a reduction in vascular complications and length of hospital stay when compared with the femoral approach. These findings suggest that where facilities and experience allow rescue angioplasty in patients with acute myocardial infarction should be performed via the radial artery.
Cruden
Nicholas L M
NL
Centre for Cardiovascular Science, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. nick.cruden@ukonline.co.uk
Teh
Chun H
CH
Starkey
Ian R
IR
Newby
David E
DE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D017534:Radial Artery / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015912:Thrombolytic Therapy; D016896:Treatment Outcome