Related Experiment Video
Updated: Mar 18, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Comparison of Safety and Effectiveness Between Right Versus Left Radial Arterial Access in Primary Percutaneous
Mahmoud Farouk Elmahdy1, Mohamed ElMaghawry2, Mohamed Hassan3
1Cardiology Department, Cairo University, Cairo, Egypt; Cardiology Department, Aswan Heart Centre, Aswan, Egypt.
Insights
Right radial access and left radial access are equally safe and effective for primary percutaneous intervention in ST-elevation myocardial infarction patients. Both approaches demonstrate high success rates and comparable outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Transradial approach (TRA) is standard for percutaneous coronary intervention (PCI).
- TRA in ST-elevation myocardial infarction (STEMI) reduces major adverse cardiac events.
- The impact of radial access side (right vs. left) on TRA safety and effectiveness in primary PCI remains unclear.
Purpose of the Study:
- To compare the safety, feasibility, and outcomes of right radial access (RRA) versus left radial access (LRA) in primary PCI for STEMI patients.
Main Methods:
- Retrospective analysis of 400 consecutive STEMI patients undergoing primary PCI.
- Patients were divided into RRA and LRA groups.
- Demographics, clinical characteristics, and procedural data were analyzed.
Main Results:
- No significant difference in demographics or clinical characteristics between RRA (202 patients) and LRA (198 patients) groups.
- Procedure success rates were high and similar: 97.5% for RRA vs. 98.4% for LRA (P=0.77).
- No significant differences observed in contrast volume, catheter use, fluoroscopy time, needle-to-balloon time, or post-procedure complications (vascular complications, reinfarction, stroke/TIA, death).
Conclusions:
- Right radial access and left radial access are equally safe and effective for primary PCI in STEMI.
- Both RRA and LRA offer high success rates and comparable procedural times.
- The choice of radial access side does not appear to impact outcomes in primary PCI for STEMI.
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.
Conclusion:
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.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:24Cardiac Catheterization III: Left Heart Catheterization
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:21Cardiac Catheterization II: Right Heart Catheterization
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:28Cardiac Catheterization I: Pre-Procedure Overview