CRM: Transradial PCI in STEMI proves safe, effective in five-year experience
The transradial (TR) approach is a safe and effective way to treat ST-segment-elevation MI (STEMI) patients during PCI procedures, compared to a transfemoral (TF) approach, according to a retrospective, five-year study in the April-June issue of Cardiovascular Revascularization Medicine. In fact, site-related complications are less common with this approach.

PCI via radial approach has been shown to be an alternative to femoral approach in emergency cases; however, its feasibility has been questioned. Zoltán Ruzsa, MD, and colleagues from the division of invasive cardiology at the University of Szeged in Hungary said that the single-center study was performed to compare the outcomes and complication rates between TR and TF PCI in STEMI patients.

The researchers evaluated the clinical and angiographic data of 582 consecutive STEMI patients treated with PCI between 2001 and 2006. They noted that 43 patients were excluded from the present study due to cardiogenic shock or rescue PCI.

Investigators categorized the 539 patients into the TR group (167) or the TF group (372), and used several parameters 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 one month, and consumption of angioplasty equipment.

In the TR group, Ruzsa and colleagues found that the crossover rate to femoral access was 5 percent, while in the TF group, it was 0.8 percent. There was a significant difference, in both major and minor access-site complications, between the TR group and the TF group (0 vs. 5 percent, and 4 vs. 9 percent, respectively).

The authors wrote that the consumption of angioplasty equipment proved to be the same for the two groups. The MACE rate was 4 percent in the TR group and 11 percent in the TF group.

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