title: Femoral versus radial access in primary angioplasty. Analysis of the ACCEPT registry.
abstract: BACKGROUND
  The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention.
  
  
  OBJECTIVE
  To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route.
  
  
  METHODS
  From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure.
  
  
  RESULTS
  The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used.
  
  
  CONCLUSIONS
  The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.
authors.affiliation: Santa Casa de Misericórdia de Marília, São Paulo, SP, Brazil.
authors.forename: Pedro Beraldo de
authors.initials: PB
authors.lastname: Andrade
authors.affiliation: Santa Casa de Misericórdia de Marília, São Paulo, SP, Brazil.
authors.forename: Mônica Vieira Athanazio de
authors.initials: MV
authors.lastname: Andrade
authors.affiliation: Santa Casa de Misericórdia de Marília, São Paulo, SP, Brazil.
authors.forename: Robson Alves
authors.initials: RA
authors.lastname: Barbosa
authors.affiliation: Santa Casa de Misericórdia de Marília, São Paulo, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Labrunie
authors.affiliation: Santa Casa de Votuporanga, São Paulo, SP, Brazil.
authors.forename: Mauro Esteves
authors.initials: ME
authors.lastname: Hernandes
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, BRAZIL.
authors.forename: Roberto Luiz
authors.initials: RL
authors.lastname: Marino
authors.affiliation: Sociedade Hospital Angelina Caron, Campina Grande do Sul, PR, Brasil.
authors.forename: Dalton Bertolim
authors.initials: DB
authors.lastname: Precoma
authors.affiliation: Hospital do Coração do Cariri, Barbalha, CE, Brazil.
authors.forename: Francisco Carleial Feijó de
authors.initials: FC
authors.lastname: Sá
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP, Brazil.
authors.forename: Otávio
authors.initials: O
authors.lastname: Berwanger
authors.affiliation: Sociedade Brasileira de Cardiologia, São Paulo, SP, Brazil.
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Piva e Mattos
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D017534:Radial Artery / Q000601:surgery*; D012042:Registries / Q000706:statistics & numerical data*; D016896:Treatment Outcome