Safety and efficacy of transradial vs transfemoral arterial primary coronary angioplasty for acute myocardial infarction: single-center experience.
BACKGROUND
The aim of the present study was to test the hypothesis that the transradial arterial approach (TRA) is not inferior to the transfemoral arterial approach (TFA) for <or=Killip 3 acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PCI).


RESULTS
This study enrolled 506 AMI patients undergoing primary PCI using the TRA (group 1) between March 2002 and May 2007, and 810 AMI patients undergoing primary PCI using TFA (group 2) between May 1993 and February 2002. The results demonstrated that puncture to first balloon-inflation time was similar in both groups; however, the procedure time was shorter in group 1 than in group 2 (P<0.0001). Additionally, the incidences of stenting, tirofiban therapy and final normal coronary blood flow of the infarct-related artery were higher, whereas the frequency of intra-aortic balloon pump support was lower in group 1 than in group 2 (all P<0.02). Although the 30-day mortality rate did not differ between the 2 groups (P=0.341), the rate of combined major vascular and bleeding complications was higher in group 2 than in group 1 (P<0.0001).


CONCLUSIONS
Initial selection of TRA is not inferior to initial selection of TFA for AMI patients undergoing primary PCI. However, in the present study, the incidence of combined vascular and bleeding complications was lower with the TRA than with the TFA approach.
Yip
Hon-Kan
HK
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University Collage of Medicine, Kaohsiung, Taiwan, ROC.
Chung
Sheng-Ying
SY
Chai
Han-Tan
HT
Youssef
Ali A
AA
Bhasin
Anuj
A
Yang
Cheng-Hsu
CH
Chen
Shyh-Ming
SM
Hang
Chi-Ling
CL
Hsieh
Yuan-Kai
YK
Chen
Chien-Jen
CJ
Chang
Li-Teh
LT
Sun
Cheuk-Kwan
CK
Wu
Chiung-Jen
CJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D003326:Coronary Circulation; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D017534:Radial Artery; D012449:Safety; D015607:Stents; D013997:Time Factors; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000925:Anticoagulants; D014443:Tyrosine; D000077466:Tirofiban