Unprotected Left Main Primary PCI via Distal Transradial Access in the Setting of STEMI-Related Cardiogenic Shock

Area of Science:

• Interventional Cardiology
• Vascular Access Techniques

Background:

• Transradial access (TRA) is preferred for coronary angiography and percutaneous coronary intervention (PCI) due to its benefits.
• However, patients with cardiogenic shock often undergo transfemoral access (TFA) due to difficulties with radial artery puncture during hemodynamic instability.

Observation:

• A case of ST-elevation myocardial infarction (STEMI)-related cardiogenic shock necessitated primary PCI.
• The procedure involved an occluded and unprotected left main coronary artery.

Findings:

• The primary PCI was successfully and safely performed using a right distal transradial access approach in the anatomical snuffbox.
• This demonstrates the feasibility of distal TRA in a high-risk patient population.

Implications:

• Distal transradial access may be a viable and safe alternative to TFA in patients with STEMI and cardiogenic shock.
• This technique could expand the application of TRA in complex interventional cardiology cases, improving patient outcomes.