Key result
Radial PCI in STEMI yields similar door-to-balloon times compared to femoral access.
Why the study?
Does the transradial approach increase door-to-balloon time compared to the transfemoral approach in patients with STEMI undergoing primary PCI?
Cohort (n=49)
Does the transradial approach increase door-to-balloon time compared to the transfemoral approach in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 100.32% vs 97.31%
p-value: p=0.522
The transradial approach for primary PCI in STEMI does not significantly delay door-to-balloon time compared to the transfemoral approach and is associated with high angiographic success.
Primary percutaneous coronary intervention (pPCI) is considered the preferred reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). This study compares the door-to-balloon (D2B) time between transradial vs. the transfemoral approach in patients presenting with STEMI. Methods A retrospectively collected catheterization laboratory database was reviewed for the consecutive patients presenting with a STEMI. Specific time parameters were recorded, and our composite end points were time to revascularization, angiographic success, short term clinical success, and procedural vascular complications. Results Radial PCI (r-PCI) was performed in 33 patients (67.3%) and in 16 patients (32.7%) PCI was done through femoral artery (f-PCI). No significant difference was observed in the pre-catheter and catheter laboratory times. Mean times from emergency room door-to-catheter laboratory time for r-PCI vs. f-PCI were 82.48 ± 37.42 and 76.29 ± 34.32 min, respectively ( P = 0.636). The mean time from patient arrival to the cardiac catheter laboratory-to-balloon inflation was 34.56 ± 14.2 in the r-PCI group vs. 33.12 ± 12.56 min with the f-PCI group ( P = 0.215). The total D2B time was not significantly different between r-PCI vs. f-PCI groups (100.32 ± 36.3 vs. 97.31 ± 30.37 min, respectively, P = 0.522). Angiographic success rates were observed in 92.1% of the patients for r-PCI, and in 87.5% for f-PCI ( P = 0.712). There were no vascular complications in both groups. Conclusions Patients presenting with STEMI can undergo successful pPCI via radial artery without compromising patient care.
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Tayeh et al. (2013) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=49). Radial approach (r-PCI) vs. Femoral approach (f-PCI) was evaluated on Total door-to-balloon (D2B) time (p=0.522). The radial approach for primary PCI in STEMI patients resulted in similar total door-to-balloon times compared to the femoral approach (100.32 vs. 97.31 minutes; P=0.522).
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