Five-year experience with transradial coronary angioplasty in ST-segment-elevation myocardial infarction

• Published in: Cardiovascular revascularization medicine Vol. 10; no. 2; pp. 73 - 79
• Main Authors: Ruzsa, Zoltán, Ungi, Imre, Horváth, Tamás, Sepp, Róbert, Zimmermann, Zsolt, Thury, Attila, Jambrik, Zoltán, Sasi, Viktor, Tóth, Gábor, Forster, Tamás, Nemes, Attila
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2009
• Subjects: Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - methods; Cardiovascular; Cardiovascular Diseases - etiology; Complication; Coronary Angiography; Female; Femoral Artery; Humans; Male; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - therapy; Percutaneous coronary intervention; Platelet Aggregation Inhibitors - therapeutic use; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors; Radial Artery; Retrospective Studies; Stents - utilization; Time Factors; Transfemoral; Transradial; Treatment Outcome; Transfemoral; Complication; Percutaneous coronary intervention; Transradial
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2008.07.004

Abstract Background and purpose Percutaneous coronary intervention (PCI) via radial approach has been shown to be an alternative to femoral approach in emergency cases; however, its feasibility has been questioned. This single-center study was performed to compare the outcomes and complication rates between transradial (TR) and transfemoral (TF) PCI in ST-segment-elevation myocardial infarction (STEMI). Methods and materials The clinical and angiographic data of 582 consecutive STEMI patients treated with PCI between 2001 and 2006 were evaluated in a retrospective study. Forty-three patients were excluded from the present study due to cardiogenic shock or rescue PCI. Patients ( n =539) were categorized into the TR group ( n =167) or the TF group ( n =372), and several parameters were evaluated to assess the advantages and drawbacks of TR access: access-site crossover, rate of access-site complications, procedure time, fluoroscopy time, X-ray area dose, major adverse cardiac events (MACE) at 1 month, and consumption of angioplasty equipment. Results In the TR group, the crossover rate to femoral access was 5%, while in the TF group, it was 0.8% ( P <.05). There was a significant difference, in both major and minor access-site complications, between the TR group and the TF group (0% vs. 5%, P <.05, and 4% vs. 9%, P <.05, respectively). Consumption of angioplasty equipment proved to be the same for the two groups. The MACE rate was 4% in the TR group and 11% in the TF group ( P <.05). Conclusions Our results suggest that the TR approach is a safe and effective way to treat STEMI; furthermore, site-related complications are less common with this approach.