title: Reducing needle-to-balloon time by using a single guiding catheter during transradial primary coronary intervention.
abstract: OBJECTIVE
  It is unknown whether using a single guiding catheter for both nonculprit and culprit vessel angiography and intervention during transradial primary percutaneous coronary intervention (PCI) is feasible.
  
  
  METHODS
  This single-center study enrolled 242 consecutive patients with ST segment elevation myocardial infarction (STEMI) who received primary PCI. Among them, 102 patients received primary PCI via transfemoral approach (TFI), 109 patients received primary PCI via transradial approach using conventional technique (Conventional TRI), and 31 underwent primary TRI using a single guiding catheter (Single Guiding TRI). The catheter used for this purpose was 6 Fr RM® 3.5 guiding catheter.
  
  
  RESULTS
  Using a single guiding catheter, both coronary artery angiograms and intervention were successful in 30 of 31 patients (96.7%). Needle-to-balloon time (from puncture to first balloon) and door-to-balloon (D2B) time were similar between TFI and Conventional TRI groups and significantly lower in the Single Guiding TRI group (13.8 [TFI] and 14.1 [Conventional TRI] vs. 7.6 minutes, P < 0.001; 89.5 [TFI] and 91.0 [Conventional TRI] vs. 68.5 minutes, P = 0.008, respectively), whereas proportion of patients achieving D2B time within 90 minutes increased significantly in the Single Guiding TRI group from 51.0% for TFI and 49.5% for Conventional TRI to 74.2% (P = 0.023).
  
  
  CONCLUSIONS
  Primary transradial PCI using a single guiding catheter is feasible and highly successful and might allow timely restoration of blood flow in infarct-related artery.
authors.affiliation: Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Keon-Woong
authors.initials: KW
authors.lastname: Moon
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Ju-Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Mi-Hyang
authors.initials: MH
authors.lastname: Jung
authors.forename: Gee-Hee
authors.initials: GH
authors.lastname: Kim
authors.forename: Ki-Dong
authors.initials: KD
authors.lastname: Yoo
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Kim
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery; D013997:Time Factors; D016896:Treatment Outcome