Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction

Qiang Fu, Hongyu Hu, Dezhao Wang, Wei Chen, Zhixu Tan, Qun Li, Buxing Chen Department of Cardiology, Beijing Titantan Hospital, Capital Medical University, Beijing, People’s Republic of China Background: Growing evidence suggests that the left radial approach (LRA) is related to decrease...

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Autores principales:	Fu Q, Hu H, Wang D, Chen W, Tan Z, Li Q, Chen B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Transradial approach Primary percutaneous coronary intervention ST-segment elevation myocardial infarction Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/218d02c720e64b4dbe2ba105de6720e2
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spelling	oai:doaj.org-article:218d02c720e64b4dbe2ba105de6720e22021-12-02T03:34:05ZRandomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction1178-1998https://doaj.org/article/218d02c720e64b4dbe2ba105de6720e22015-06-01T00:00:00Zhttps://www.dovepress.com/randomized-comparative-study-of-left-versus-right-radial-approach-in-t-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Qiang Fu, Hongyu Hu, Dezhao Wang, Wei Chen, Zhixu Tan, Qun Li, Buxing Chen Department of Cardiology, Beijing Titantan Hospital, Capital Medical University, Beijing, People’s Republic of China Background: Growing evidence suggests that the left radial approach (LRA) is related to decreased coronary procedure duration and fewer cerebrovascular complications as compared to the right radial approach (RRA) in elective percutaneous coronary intervention (PCI). However, the feasibility of LRA in primary PCI has yet to be studied further. Therefore, the aim of this study was to investigate the efficacy of LRA compared with RRA for primary PCI in ST-elevation myocardial infarction (STEMI) patients.Materials and methods: A total of 200 consecutive patients with STEMI who received primary PCI were randomized to LRA (number [n]=100) or RRA (n=100). The study endpoint was needle-to-balloon time, defined as the time from local anesthesia infiltration to the first balloon inflation. Radiation dose by measuring cumulative air kerma (CAK) and CAK dose area product, as well as fluoroscopy time and contrast volume were also investigated.Results: There were no significant differences in the baseline characteristics between the two groups. The coronary procedural success rate was similar between both radial approaches (98% for left versus 94% for right; P=0.28). Compared with RRA, LRA had significantly shorter needle-to-balloon time (16.0±4.8 minutes versus 18.0±6.5 minutes, respectively; P=0.02). Additionally, fluoroscopy time (7.4±3.4 minutes versus 8.8±3.5 minutes, respectively; P=0.01) and CAK dose area product (51.9±30.4 Gy cm2 versus 65.3±49.1 Gy cm2, respectively; P=0.04) were significantly lower with LRA than with RRA.Conclusion: Primary PCI can be performed via LRA with earlier blood flow restoration in the infarct-related artery and lower radiation exposure when compared with RRA; therefore, the LRA may become a feasible and attractive alternative to perform primary PCI for STEMI patients. Keywords: transradial approach, primary percutaneous coronary intervention, ST-segment elevation myocardial infarctionFu QHu HWang DChen WTan ZLi QChen BDove Medical PressarticleTransradial approachPrimary percutaneous coronary interventionST-segment elevation myocardial infarctionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1003-1008 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Transradial approach Primary percutaneous coronary intervention ST-segment elevation myocardial infarction Geriatrics RC952-954.6
spellingShingle	Transradial approach Primary percutaneous coronary intervention ST-segment elevation myocardial infarction Geriatrics RC952-954.6 Fu Q Hu H Wang D Chen W Tan Z Li Q Chen B Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
description	Qiang Fu, Hongyu Hu, Dezhao Wang, Wei Chen, Zhixu Tan, Qun Li, Buxing Chen Department of Cardiology, Beijing Titantan Hospital, Capital Medical University, Beijing, People’s Republic of China Background: Growing evidence suggests that the left radial approach (LRA) is related to decreased coronary procedure duration and fewer cerebrovascular complications as compared to the right radial approach (RRA) in elective percutaneous coronary intervention (PCI). However, the feasibility of LRA in primary PCI has yet to be studied further. Therefore, the aim of this study was to investigate the efficacy of LRA compared with RRA for primary PCI in ST-elevation myocardial infarction (STEMI) patients.Materials and methods: A total of 200 consecutive patients with STEMI who received primary PCI were randomized to LRA (number [n]=100) or RRA (n=100). The study endpoint was needle-to-balloon time, defined as the time from local anesthesia infiltration to the first balloon inflation. Radiation dose by measuring cumulative air kerma (CAK) and CAK dose area product, as well as fluoroscopy time and contrast volume were also investigated.Results: There were no significant differences in the baseline characteristics between the two groups. The coronary procedural success rate was similar between both radial approaches (98% for left versus 94% for right; P=0.28). Compared with RRA, LRA had significantly shorter needle-to-balloon time (16.0±4.8 minutes versus 18.0±6.5 minutes, respectively; P=0.02). Additionally, fluoroscopy time (7.4±3.4 minutes versus 8.8±3.5 minutes, respectively; P=0.01) and CAK dose area product (51.9±30.4 Gy cm2 versus 65.3±49.1 Gy cm2, respectively; P=0.04) were significantly lower with LRA than with RRA.Conclusion: Primary PCI can be performed via LRA with earlier blood flow restoration in the infarct-related artery and lower radiation exposure when compared with RRA; therefore, the LRA may become a feasible and attractive alternative to perform primary PCI for STEMI patients. Keywords: transradial approach, primary percutaneous coronary intervention, ST-segment elevation myocardial infarction
format	article
author	Fu Q Hu H Wang D Chen W Tan Z Li Q Chen B
author_facet	Fu Q Hu H Wang D Chen W Tan Z Li Q Chen B
author_sort	Fu Q
title	Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
title_short	Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
title_full	Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
title_fullStr	Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
title_full_unstemmed	Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction
title_sort	randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for st-elevation myocardial infarction
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/218d02c720e64b4dbe2ba105de6720e2
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Randomized comparative study of left versus right radial approach in the setting of primary percutaneous coronary intervention for ST-elevation myocardial infarction

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