title: Comparison between transradial and transfemoral percutaneous coronary intervention in acute ST-elevation myocardial infarction.
abstract: Transradial (TR) access is increasingly being used in percutaneous coronary intervention (PCI). However, its role in PCI for ST-segment elevation myocardial infarction remains controversial because of concerns of procedural complexity adversely affecting the promptness of reperfusion. In this study, 150 consecutive patients who underwent PCI for acute ST-segment elevation myocardial infarction over a period of 24 months were prospectively evaluated; 46 had TR access (31%) and 104 (69%) had transfemoral (TF) access. All patients received thienopyridines, aspirin, and heparin per routine management. There were no significant differences between the TR access and TF access groups with respect to age (62.2 ± 11.6 vs 64.7 ± 14.1, p = 0.28), gender (76.1% vs 72.1% men, p = 0.69), or incidence of diabetes (23.9% vs 26.9%, p = 0.84). The TR and TF access groups were comparable with respect to door-to-balloon time (79.2 ± 32.3 vs 86.8 ± 51.8 minutes, p = 0.67) and amount of contrast used (190.5 ± 101.5 vs 172.2 ± 81.7 ml, p = 0.24). Total fluoroscopy time was longer in the TR access group compared to the TF access group (21.7 ± 12.7 vs 14.4 ± 10.4 minutes, p <0.0001). Postprocedural Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow was comparable for the 2 groups (87% for the TF group and 96% for the TR group, p = 0.15). There were no vascular complications in the TR access group compared to the TF access group (0% vs 5.8%, p = 0.18). In conclusion, this single-center observational study shows that TR access for PCI in STEMI is feasible and that it has fewer vascular complications and shorter length of hospital stay than the TF approach.
authors: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors: Uzoma N
authors: UN
authors: Ibebuogu
authors: Bojan
authors: B
authors: Cercek
authors: Rajendra
authors: R
authors: Makkar
authors: Harrison
authors: H
authors: Dinh
authors: Collins
authors: C
authors: Kwarteng
authors: James
authors: J
authors: Mirocha
authors: Asma
authors: A
authors: Hussaini
authors: Sarabjeet
authors: S
authors: Singh
authors: Suhail
authors: S
authors: Dohad
authors: Prediman K
authors: PK
authors: Shah
authors: Mehran
authors: M
authors: Khorsandi
authors: Saibal
authors: S
authors: Kar
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005263:Femoral Artery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000401:mortality; D011446:Prospective Studies; D017534:Radial Artery; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents