Volume 70, Issue 5 pp. 670-675
Coronary Artery Disease

Reduced vascular complications and length of stay with transradial rescue angioplasty for acute myocardial infarction

Nicholas L.M. Cruden BSc (Hons), MB ChB, MRCP

Corresponding Author

Nicholas L.M. Cruden BSc (Hons), MB ChB, MRCP

Centre for Cardiovascular Science, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

Department of Cardiology, Western General Hospital, Edinburgh, United Kingdom

Department of Cardiology, Western General Hospital, Edinburgh EH4 2XU, United KingdomSearch for more papers by this author
Chun H. Teh

Chun H. Teh

Centre for Cardiovascular Science, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

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Ian R. Starkey BSc (Hons), MB, ChB (Hons), FRCP

Ian R. Starkey BSc (Hons), MB, ChB (Hons), FRCP

Department of Cardiology, Western General Hospital, Edinburgh, United Kingdom

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David E. Newby PhD, BM, DM, FRCP

David E. Newby PhD, BM, DM, FRCP

Centre for Cardiovascular Science, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

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First published: 11 June 2007
Citations: 62

Abstract

Objectives:

The aim of this study was to compare clinical outcomes for transradial and transfemoral percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction undergoing rescue angioplasty.

Background:

Transfemoral percutaneous coronary intervention in patients with acute myocardial infarction treated with systemic thrombolysis is associated with a significant risk of vascular complications. A transradial approach may reduce vascular complications, improve mobilization and facilitate earlier discharge.

Methods:

In a retrospective analysis, clinical outcomes for 287 consecutive patients undergoing rescue angioplasty for acute myocardial infarction were determined. Data were recorded using a standardized proforma and analyzed using SPSS.

Results:

Procedural success was similar for the transradial and transfemoral routes (98% vs. 93%; P = 0.3). There was a reduction in vascular complications (0 (0%) vs. 32 (13%); P < 0.01) and post-procedural length of stay (7.0 ± 7.9 vs. 7.9 ± 5.6 days; P < 0.005) in the radial group when compared with the femoral group. There were no differences in procedural or in-hospital mortality, procedure duration, or radiation dose between the two groups.

Conclusion:

Rescue angioplasty performed via the radial artery is safe, effective, and associated with a reduction in vascular complications and length of hospital stay when compared with the femoral approach. These findings suggest that where facilities and experience allow rescue angioplasty in patients with acute myocardial infarction should be performed via the radial artery. © 2007 Wiley-Liss, Inc.

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