title: Transradial access as first choice for primary percutaneous coronary interventions: experience from a tertiary hospital in Athens.
abstract: BACKGROUND
  The transfemoral approach (TFA) has been the mainstay for arterial access during percutaneous coronary intervention (PCI) in the setting of acute ST-segment elevation myocardial infarction (STEMI). However, the transradial approach (TRA) has been shown to be an equally effective and possibly safer way of performing primary PCI (pPCI).
  
  
  METHODS
  The study population included 98 serially recruited patients who underwent pPCI in our institution. All patients were clinically followed during their hospital stay (6.4 ± 3.1 days).
  
  
  RESULTS
  In the 98 patients included in the study, 65 procedures (66.3%) were completed via TRA, whereas the remaining 33 procedures (33.7%) used TFA. Door-to-balloon time was similar (57 ± 19 min vs. 54 ± 15 min, p=ns). Patients in the TRA group were mobilized sooner (28 ± 9 hours vs. 36 ± 13 hours, p<0.05). Hospital stay was significantly shorter in the TRA group (6.0 ± 3.2 days vs. 7.1 ± 2.8 days, p<0.05). TRA and TFA did not differ significantly as to the incidence of death, non-fatal myocardial infarction or subacute stent thrombosis, but major access-related vascular complications were significantly more frequent in the TFA group (2% vs. 15%, p<0.01). Cerebrovascular events did not differ between TRA and TFA.
  
  
  CONCLUSIONS
  Compared to TFA, TRA seems to be associated with a lower incidence of bleeding complications, as well as earlier mobilization and discharge from hospital. It is conceivable that TRA could become the first choice in the treatment of STEMI patients in the near future, while TFA is kept as an alternative.
authors.affiliation: Department of Cardiology, Athens General Hospital G. Gennimatas Athens, Greece. sp.g.deft@gmail.com
authors.forename: Spyridon
authors.initials: S
authors.lastname: Deftereos
authors.forename: Georgios
authors.initials: G
authors.lastname: Giannopoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Raisakis
authors.forename: Andreas
authors.initials: A
authors.lastname: Kaoukis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Kossyvakis
authors.forename: Loukas
authors.initials: L
authors.lastname: Pappas
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Panagopoulou
authors.forename: Aggeliki-Despoina
authors.initials: AD
authors.lastname: Mavrogianni
authors.forename: Andreas
authors.initials: A
authors.lastname: Theodorakis
authors.forename: Anastasia
authors.initials: A
authors.lastname: Perpinia
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Michelakakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Bobotis
authors.forename: Vlasios
authors.initials: V
authors.lastname: Pyrgakis
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002406:Catheterization, Peripheral; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D018579:Patient Selection; D017534:Radial Artery; D012189:Retrospective Studies; D016896:Treatment Outcome