Transradial access for primary angioplasty

Transradial access for primary angioplasty

Transradial access for primary angioplasty: Trans radial vascular access is gaining popularity for both elective and primary angioplasty in acute myocardial infarction. It is well known that trans radial access has lower access site bleeding compared to trans femoral route. It is also equally well known that bleeding and consequent need for blood product transfusions can cause higher mortality in myocardial infarction patients undergoing percutaneous coronary intervention. In a retrospective analysis, Valgimigli M and associates from Italy have evaluated whether transradial or transfemoral access is better for primary angioplasty in acute myocardial infarction [Transradial Versus Transfemoral Intervention for Acute Myocardial Infarction. A Propensity Score-Adjusted and -Matched Analysis From the REAL (REgistro regionale AngiopLastiche dell’Emilia-Romagna) Multicenter Registry. JACC Cardiovasc Interv. 2012; 5:23-35]. Of a total of over eleven thousand patients who underwent primary percutaneous intervention for acute myocardial infarction, eight thousand had trans femoral access while over three thousand had transradial access. It was interesting to note that the two year risk adjusted mortality rates were lower for transradial than transfemoral route (8.8% vs. 11.4%; p = 0.0250). There was also a similar lower rate of vascular complications requiring surgery or needing blood transfusion in the trans radial group (1.1% vs. 2.5%, p = 0.0052).