title: A comparison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervention for acute myocardial infarction in the elderly.
abstract: BACKGROUND
  Access site complications are reduced using radial percutaneous coronary intervention (PCI). There is concern that technical difficulties using this approach can delay achievement of reperfusion during primary or rescue PCI for acute myocardial infarction (AMI) especially in elderly patients.
  
  
  RESULTS
  We studied 155 patients (pts) > or = 70 years who underwent primary or rescue PCI for AMI; radial (Group1; 87 pts) or femoral (Group2; 68 pts). Baseline characteristics, the amount of IIB/IIIA inhibitor, contrast and heparin used, and TIMI flow pre and post PCI were similar in both groups (P>0.05). Time from arrival in the catheterization laboratory to the first balloon inflation (Group 1: 44.0+/-21.5 versus Group 2 38.8+/-18.7 min) was also similar, but was significantly longer (61.2+/-11.1 min) compared to both groups in patients with a failed radial approach (7 pts, 8%). Angiographic success, and in-hospital MACE were also similar in the two groups, but vascular access site complications were significantly higher in Group 2 (0 versus 2.9%, P<0.05).
  
  
  CONCLUSIONS
  The use of the radial approach in elderly patients undergoing primary and rescue PCI, when successful, is safe and effective as the femoral approach, and leads to fewer vascular complications.
authors.affiliation: Royal Jubilee Hospital, Victoria, BC, Canada.
authors.forename: Antonios
authors.initials: A
authors.lastname: Ziakas
authors.forename: Abuzeid
authors.initials: A
authors.lastname: Gomma
authors.forename: John
authors.initials: J
authors.lastname: McDonald
authors.forename: Peter
authors.initials: P
authors.lastname: Klinke
authors.forename: David
authors.initials: D
authors.lastname: Hilton
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D017534:Radial Artery; D012189:Retrospective Studies; D016896:Treatment Outcome