The Clinical Feasibility of Transradial Primary Percutaneous Coronary Intervention with an ST Elevation Acute Myocardial Infarction

Background and Objectives:With the lower incidence of bleeding complications and earlier ambulation, transradial coronary intervention (TRI) is related with improved patient satisfaction compared with that of conventional transfemoral intervention (TFI). However, there is insufficient data about the efficacy of TRI in patients with an acute ST segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the safety and efficacy of TRI in selected patients with an acute STEMI. Subjects and Methods:Between March 2003 to August 2006, 386 acute STEMI patients were treated using primary percutaneous coronary intervention (PCI), of which 335 had undergone TRI and were included in the study. This study was performed retrospectively on 335 consecutive patients, including 246 males, with a mean age of 62±11 years. Results:Hemodynamically stable patients (n=335) underwent primary PCI via TRI. Fourteen of the TRI cases were changed to the TFI group during the procedure. The procedural success rate was 96%. The mean time interval from arterial access to balloon dilatation and total procedure time were 13.4±7.1 and 37±18 min, respectively. A 6 French sized guiding catheter was used in 235 cases (70%). There were no major bleeding complications, and the mean duration of hospital stay was 4.7±4.9 days. Conclusion:In the setting of primary PCI, TRI can be a feasible and safe approach in selected hemodynamically stability patients. (Korean Circulation J 2007;37:72-77)