Nassar, A., El Mahmoudy, A., El Missiry, A., El Etriby, S. (2016). The Impact of Transradial versus Transfemoral Approach for Percutaneous Coronary Intervention on the Outcome of Patients Presenting with Acute Coronary Syndrome. The Egyptian Journal of Hospital Medicine, 62(1), 57-64. doi: 10.12816/0021414
Ahmed Ibrahim Nassar; Ahmed Mohamed El Mahmoudy; Ahmed Mohamed El Missiry; Shehab Adel El Etriby. "The Impact of Transradial versus Transfemoral Approach for Percutaneous Coronary Intervention on the Outcome of Patients Presenting with Acute Coronary Syndrome". The Egyptian Journal of Hospital Medicine, 62, 1, 2016, 57-64. doi: 10.12816/0021414
Nassar, A., El Mahmoudy, A., El Missiry, A., El Etriby, S. (2016). 'The Impact of Transradial versus Transfemoral Approach for Percutaneous Coronary Intervention on the Outcome of Patients Presenting with Acute Coronary Syndrome', The Egyptian Journal of Hospital Medicine, 62(1), pp. 57-64. doi: 10.12816/0021414
Nassar, A., El Mahmoudy, A., El Missiry, A., El Etriby, S. The Impact of Transradial versus Transfemoral Approach for Percutaneous Coronary Intervention on the Outcome of Patients Presenting with Acute Coronary Syndrome. The Egyptian Journal of Hospital Medicine, 2016; 62(1): 57-64. doi: 10.12816/0021414
The Impact of Transradial versus Transfemoral Approach for Percutaneous Coronary Intervention on the Outcome of Patients Presenting with Acute Coronary Syndrome
Department of cardiology, Faculty of Medicine, Ain Shams University
Abstract
Background: the transfemoral approach (TFA) has been until presently the main-stay for arterial access PCI in the setting of acute STEMI, while the transradial approach (TRA) is gaining ground in elective as well as primary procedures. Objectives: to assess the impact of transradial versus transfemoral approach for PCI on the outcome of patients presenting with acute coronary syndrome. Patients and Methods: prospective study was conducted on 100 patients presenting to Ain Shams University Hospitals Coronary Care Unit (CCU) with recent onset acute coronary syndrome (whether unstable angina (UA)/non–ST-segment-elevation MI (NSTEMI) or ST-segment-elevation MI (STEMI)) undergoing revascularization via percutaneous coronary intervention (PCI). Patients were randomized into 2 equal groups, for the first group PCI was performed via TFA while for the second group via TRA. Results: our study found that, with TRA we get less bleeding, less local vascular complications [8 (16%) vs 2 (4%), p=0.045] & less amount of dye used (169.60 ± 21.28 versus 187.00 ± 37.65 ml, p=0.006) without significant increase in fluoroscopy time (10.86 ±4.88 versus 9.76 ±4.74 mins, p=0.256) or radiation exposure. Although there was no significant difference in mortality and morbidity, TRA offers the patient a more simple procedure with less hospital stay (3.4 ±0.948 versus 3.86 ±0.808 days, p<0.01). Conclusion: radial artery access is a safe and effective approach for management of ACS. If performed by experienced operators, TRA should be the standard access in managing ACS specifically in STEMI.
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