title: Safety and efficacy of transradial vs transfemoral arterial primary coronary angioplasty for acute myocardial infarction: single-center experience.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University Collage of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
authors.forename: Sheng-Ying
authors.initials: SY
authors.lastname: Chung
authors.forename: Han-Tan
authors.initials: HT
authors.lastname: Chai
authors.forename: Ali A
authors.initials: AA
authors.lastname: Youssef
authors.forename: Anuj
authors.initials: A
authors.lastname: Bhasin
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Yang
authors.forename: Shyh-Ming
authors.initials: SM
authors.lastname: Chen
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Hang
authors.forename: Yuan-Kai
authors.initials: YK
authors.lastname: Hsieh
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Li-Teh
authors.initials: LT
authors.lastname: Chang
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: Chiung-Jen
authors.initials: CJ
authors.lastname: Wu
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D014443:Tyrosine; D000077466:Tirofiban