Abstract 13427: Radial Versus Femoral Access for Primary Percutaneous Coronary Intervention: Single Center Study of 928 Consecutive Patients
Introduction: In the recently published randomised radial access (RA) versus femoral access (FA) for coronary intervention trial (RIVAL study, S. Jolly et al. The Lancet, 2011), RA was found to be superior in the pre-specified subgroup of patients presenting with ST elevation MI (STEMI). However, the STEMI patients in this study included patients receiving fibrinolysis and those undergoing facilitated percutaneous coronary intervention. We evaluated the clinical outcome of consecutive unselected patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI and compared the results according to access route.
Methods: We analysed all patients undergoing PPCI in our unit between Sept 2009 and Dec 2010. Prospectively entered data were obtained from our dedicated cardiac service database system (Philips CVIS). Procedural success was defined as having at least a thrombectomy device or balloon catheter across the culprit lesion.
Results: During the study period, 928 patients underwent PPCI for STEMI in our unit. We excluded 63 (6.8%) patients presenting with cardiogenic shock, and 14 (1.6%) patients who had both RA and FA. We therefore included 851 patients in the study. Of these, RA was used in 221 (26%) and FA in 630 patients (74%). Demographic and procedural data for both groups are given in Table 1. Procedural and clinical outcome for both groups are given in Table 2.
Conclusion: In this unselected group of consecutive patients treated with PPCI for STEMI at a single high volume center, there was a small but significant difference in door to balloon times in favour of femoral access; however, there was no significant difference in mortality at 30 days.
- Percutaneous coronary intervention
- Myocardial infarction, STEMI
- Interventional cardiology
- Acute coronary syndromes
- © 2011 by American Heart Association, Inc.