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Five-year experience with transradial coronary angioplasty in ST-segment-elevation myocardial infarction
Zoltán Ruzsa1, Imre Ungi, Tamás Horváth
1Division of Invasive Cardiology, Second Department of Medicine and Cardiology Center, Medical Faculty, Albert-Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Insights
Transradial percutaneous coronary intervention (PCI) is a safe and effective treatment for ST-segment-elevation myocardial infarction (STEMI), with fewer access-site complications compared to transfemoral PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Transradial approach (TRA) is an alternative to transfemoral approach (TFA) for percutaneous coronary intervention (PCI).
- Feasibility of TRA in emergency settings like ST-segment-elevation myocardial infarction (STEMI) requires further investigation.
Purpose of the Study:
- To compare outcomes and complication rates of transradial (TR) versus transfemoral (TF) PCI in STEMI patients.
- To evaluate the safety and efficacy of TR access in STEMI treatment.
Main Methods:
- Retrospective study of 539 STEMI patients undergoing PCI (2001-2006).
- Patients categorized into TR group (n=167) and TF group (n=372).
- Evaluated parameters included access-site crossover, complications, procedure time, fluoroscopy time, X-ray dose, major adverse cardiac events (MACE) at 1 month, and equipment consumption.
Main Results:
- TR group had a 5% crossover rate to femoral access, significantly higher than the TF group (0.8%).
- TR group showed significantly lower rates of major (0% vs. 5%) and minor (4% vs. 9%) access-site complications.
- Major adverse cardiac events (MACE) rate was significantly lower in the TR group (4%) compared to the TF group (11%).
Conclusions:
- Transradial approach is a safe and effective method for treating STEMI.
- TRA is associated with a lower incidence of access-site related complications compared to TFA.
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.
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