Key result
Transradial primary PCI matches transfemoral success while reducing access site bleeding and hospital stay.
Why the study?
Does transradial primary coronary intervention provide comparable procedural success with improved safety compared to the transfemoral approach in low-risk AMI patients?
Cohort (n=72)
No
Does transradial primary coronary intervention provide comparable procedural success with improved safety compared to the transfemoral approach in low-risk AMI patients?
Absolute Event Rate: 93% vs 95%
p-value: p=0.640
Transradial primary PCI is safe and feasible for low-risk AMI patients, achieving high reperfusion success while significantly decreasing access site bleeding and shortening hospitalization compared to the transfemoral approach.
Supports transradial feasibility in low-risk AMI; leaves open confirmation in randomized trials before practice change.
Background and Objectives:Aggressive antithrombotic therapy and transfemoral primary intervention during acute myocardial infarction (AMI) restricts the patient’s movement and may increase the risk of access site bleeding complications, and lengthen the duration of movement restriction and hospital stay. Transradial approach provides less bleeding complications and early ambulation. The purpose of this study is to know whether transradial primary intervention is safe and feasible in the patients with AMI. Materials and Method:From April 1998 to December 1998, transradial primary interventions were performed in the consecutive 28 patients (24 male, 57±7 years) by two experienced operators. The results were compared to the results of 44 (15 patients during same period, 29 during previous year) transfemoral primary interventions. Results:1) The success rates of transradial primary interventions was 93% (26/28) and comparable to 95% (42/44) of transfemoral primary interventions. 2) In transradial group, the time from the arrival of catheterization laboratory to arterial access and to reperfusion, the time from the arrival of emergency room to reperfusion were 8.1±3.4 minutes, 22.0± 5.3 minutes, and 71.7±9.2 minutes, respectively and comparable to 9.0±3.1 minutes, 21.7±5.3 minutes, and 68.9±8.1 minutes of transfemoral group, respectively. 3) The complications of the procedure were treated successfully during transradial interventions. 4) In transradial group, puncture site bleeding complications were absent though heparin was continued and mild ambulation was possible early after the procedure. The hospital stay of transradial group was 5.3±1.3 days and shorter than 7.7±4.2 days of transfemoral group. Conclusion: In the low risk patients with AMI, transradial primary intervention might be safe and feasible with acceptable time delay by the experienced operators. It might be effective to reduce access site bleeding complications and to initiate early ambulation, resulting in the shortened hospital stay. (Korean Circulation J 1999;29(2):153-160)
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Soo et al. (1999) conducted a cohort in Acute myocardial infarction (AMI) (n=72). Transradial primary coronary intervention vs. Transfemoral primary coronary intervention was evaluated on Procedural success (successful stenting or balloon angioplasty with post-TIMI 3 flow) (p=0.640). Transradial primary coronary intervention achieved a 93% success rate comparable to the 95% success of the transfemoral approach (p=0.640), while significantly reducing access site bleeding and shortening hospital stay.
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