title: Guideline recommended door-to-balloon time can be achieved in transradial primary PCI--the usefulness of a dedicated radial guide catheter.
abstract: BACKGROUND
  Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However, there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access.
  
  
  OBJECTIVE
  To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI. To determine the impact of a single dedicated radial guide catheter on CCLD2BT and D2BT in transradial PPCI compared to conventional transfemoral PPCI.
  
  
  METHODS
  The procedural and clinical outcomes of consecutive patients who had transradial primary PCI between 2005 and 2009 were included in this study and compared with a matched cohort who underwent transfemoral primary PCI.
  
  
  RESULTS
  Overall D2BT and inpatient MACE were similar between the radial (n=53) and femoral (n=53) groups (85 and 82 min, P=0.889; 0% and 1.8% P=0.317 respectively). An increase in the CCL2BT and procedural times was noted in the radial compared to the femoral group (34 min versus 29 min P=0.028; 15.8 min versus 11.6 min P=0.001). When a single radial guide catheter was used for the entire procedure, there was no difference in CCL2BT, D2BT and procedural times between the radial and femoral groups (31 min versus 29 min P=0.599; 74 min versus 82 min P=0.418; 50 min versus 47 min P=0.086).
  
  
  CONCLUSIONS
  The radial approach is safe and results in guideline recommended D2BT in STEMI. The use of a dedicated radial guide catheter reduces treatment time, demonstrating equivalent times to a femoral approach.
authors.affiliation: Monash Cardiovascular Research Centre, MonashHEART, Southern Health & Department of Medicine (MMC), Monash University, Melbourne, Australia. yuvim@y7mail.com
authors.forename: Yuvaraj
authors.initials: Y
authors.lastname: Malaiapan
authors.forename: Michael
authors.initials: M
authors.lastname: Leung
authors.forename: Walid
authors.initials: W
authors.lastname: Ahmar
authors.forename: Adam W
authors.initials: AW
authors.lastname: Hutchison
authors.forename: Sandhir
authors.initials: S
authors.lastname: Prasad
authors.forename: Therma
authors.initials: T
authors.lastname: Katticaran
authors.forename: James D
authors.initials: JD
authors.lastname: Cameron
authors.forename: Richard W
authors.initials: RW
authors.lastname: Harper
authors.forename: Ian T
authors.initials: IT
authors.lastname: Meredith
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D017534:Radial Artery; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome