title: Clinical investigation of transradial access for emergent percutaneous coronary intervention in patients with acute myocardial infarction.
abstract: BACKGROUND
  Use of intensive anticoagulation and antiplatelet therapy in acute myocardial infarction (AMI) potentially increases the risk of bleeding complications during percutaneous coronary intervention via the transfemoral route. Recently, the transradial access has been intensively employed as an alternative means for diagnostic and interventional procedures. A low incidence of vascular access site bleeding complications suggests that the transradial access is a safe alternative to the transfemoral technique in patients with AMI. The safety and efficacy of transradial access for emergent percutaneous coronary intervention in patients with AMI has not been investigated in the People's Republic of China.
  
  
  METHODS
  We analyzed data from our single-center registry on 596 consecutive patients between October 2003 and October 2010. The patients were retrospectively divided into a transradial group (n = 296) and a transfemoral group (n = 300). A dedicated doctor was appointed to collect the following data: puncture time, coronary angiography time, percutaneous coronary intervention time, X-ray exposure time, duration of hospitalization, and complication rates associated with puncture, such as puncture site bleeding, hematoma, pseudoaneurysm, and major adverse cardiac events.
  
  
  RESULTS
  There were no significant differences in baseline characteristics and angiographic findings between the two groups. There were also no significant differences in coronary angiography time (8.2 ± 2.4 versus 7.6 ± 2.0 minutes), percutaneous coronary intervention time (30 ± 6.8 versus 29.6 ± 8.1 minutes), or X-ray exposure time (4.6 ± 1.4 versus 4.4 ± 1.3 minutes) between the groups. There were significant differences in puncture time (4.4 ± 1.6 versus 2.4 ± 0.8 minutes) and duration of hospitalization (3.2 ± 1.6 versus 5.4 ± 1.8 days) between the groups (P < 0.001). The complication rate using transradial access was 2.03% (6/296) versus 6.0% (18/300) using transfemoral access (P < 0.0001).
  
  
  CONCLUSIONS
  Transradial access for emergent percutaneous coronary intervention is safe and effective in patients with AMI, and it is suggested that this route could be used more widely in these patients.
authors.affiliation: Department of Cardiology, First Affiliated hospital of Tsinghua University, Beijing, People's Republic of China.
authors.forename: Xuguang
authors.initials: X
authors.lastname: Qin
authors.forename: Weiguo
authors.initials: W
authors.lastname: Xiong
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Enben
authors.initials: E
authors.lastname: Guan
authors.forename: Chunpeng
authors.initials: C
authors.lastname: Lu
mesh_terms: D000208:Acute Disease; D000368:Aged; D002681:China; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D017534:Radial Artery; D012042:Registries; D012189:Retrospective Studies
keywords: percutaneous coronary intervention; radial artery; stent deployment; vascular access
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