Five-year experience with transradial coronary angioplasty in ST-segment-elevation myocardial infarction |
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Authors: | Zoltán Ruzsa Imre Ungi Tamás Horváth Róbert Sepp Zsolt Zimmermann Attila Thury Zoltán Jambrik Viktor Sasi Gábor Tóth Tamás Forster Attila Nemes |
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Affiliation: | 1. Royal Brompton Hospital, London SW36NP, UK;2. Imperial College, London SW36LY, UK;1. New Tokyo Hospital, Matsudo, Japan;2. Ogaki Municipal Hospital, Ogaki, Japan;3. Teikyo University School of Medicine, Tokyo, Japan;4. Kokura Memorial Hospital, Kokura, Japan;5. Saiseikai Yokohama-City Eastern Hospital, Tsurumi, Japan;6. Sendai Kousei Hospital, Sendai, Japan;7. Shonan Kamakura General Hospital, Kamakura, Japan;8. Toyohashi Heart Center, Toyohashi, Japan;9. Kishiwada Tokushukai Hospital, Osaka, Japan;10. Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan;11. Osaka City University Graduate School of Medicine, Osaka, Japan;12. University of Toyama, Toyama, Japan;13. Keio University School of Medicine, Tokyo, Japan |
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Abstract: | Background and purposePercutaneous coronary intervention (PCI) via radial approach has been shown to be an alternative to femoral approach in emergency cases; however, its feasibility has been questioned. This single-center study was performed to compare the outcomes and complication rates between transradial (TR) and transfemoral (TF) PCI in ST-segment-elevation myocardial infarction (STEMI).Methods and materialsThe clinical and angiographic data of 582 consecutive STEMI patients treated with PCI between 2001 and 2006 were evaluated in a retrospective study. Forty-three patients were excluded from the present study due to cardiogenic shock or rescue PCI. Patients (n=539) were categorized into the TR group (n=167) or the TF group (n=372), and several parameters were evaluated 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 1 month, and consumption of angioplasty equipment.ResultsIn the TR group, the crossover rate to femoral access was 5%, while in the TF group, it was 0.8% (P<.05). There was a significant difference, in both major and minor access-site complications, between the TR group and the TF group (0% vs. 5%, P<.05, and 4% vs. 9%, P<.05, respectively). Consumption of angioplasty equipment proved to be the same for the two groups. The MACE rate was 4% in the TR group and 11% in the TF group (P<.05).ConclusionsOur results suggest that the TR approach is a safe and effective way to treat STEMI; furthermore, site-related complications are less common with this approach. |
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