title: Comparison of Safety and Effectiveness Between Right Versus Left Radial Arterial Access in Primary Percutaneous Coronary Intervention for Acute ST Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Transradial approach (TRA) is now considered the standard of care in many centres for elective and primary percutaneous intervention (PCI). The use of the radial approach in ST segment elevation myocardial infarction (STEMI) patients has been associated with a significant reduction in major adverse cardiac events. However, it is still unclear if the side of radial access (right vs. left) has impact on safety and effectiveness of TRA in primary PCI. So this study was conducted to compare the safety, feasibility, and outcomes of right radial access (RRA) vs. left radial access (LRA) in the setting of primary PCI.
  
  
  METHODS
  We retrospectively analysed the data of 400 consecutive patients presenting to our institution with STEMI for whom primary PCIs were performed via RRA and LRA.
  
  
  RESULTS
  Mean age of the whole studied population was 57±12.8 years, with male predominance (77.2%). There were 202 cases in the RRA group and 198 in the LRA group, with no significant difference in demographics and clinical characteristics for patients included in both groups. There was no signiﬁcant difference in procedure success rate (97.5% for RRA vs. 98.4% for LRA; P=0.77). In addition, no significant difference between both approaches was observed in the contrast volume, number of catheters, fluoroscopy time (FT), needle-to-balloon time, post-procedure vascular complications, in hospital reinfarction, stroke/transient ischaemic attack (TIA) or death.
  
  
  CONCLUSIONS
  Right radial access and LRA are equally safe and effective in the setting of primary PCI. Both approaches have a high success rate and comparable needle-to-balloon time.
authors.affiliation: Cardiology Department, Cairo University, Cairo, Egypt; Cardiology Department, Aswan Heart Centre, Aswan, Egypt. Electronic address: drmahmoudfarouk@yahoo.com.
authors.forename: Mahmoud Farouk
authors.initials: MF
authors.lastname: Elmahdy
authors.affiliation: Cardiology Department, Aswan Heart Centre, Aswan, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: ElMaghawry
authors.affiliation: Cardiology Department, Cairo University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassan
authors.affiliation: Cardiology Department, Cairo University, Cairo, Egypt.
authors.forename: Hussien Heshmat
authors.initials: HH
authors.lastname: Kassem
authors.affiliation: Cardiology Department, Cairo University, Cairo, Egypt.
authors.forename: Karim
authors.initials: K
authors.lastname: Said
authors.affiliation: Cardiology Department, Cairo University, Cairo, Egypt.
authors.forename: Amr AbdelAziz
authors.initials: AA
authors.lastname: Elfaramawy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D017534:Radial Artery; D000072657:ST Elevation Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D012449:Safety
keywords: Primary PCI; Radial access; STEMI