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Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction

Authors
 Oh-Hyun Lee  ;  Yongcheol Kim  ;  Nak-Hoon Son  ;  Ji Woong Roh  ;  Eui Im  ;  Deok-Kyu Cho  ;  Donghoon Choi 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.10(15) : 3438, 2021-08 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2021-08
Keywords
ST-elevation myocardial infarction ; bleeding ; percutaneous coronary intervention ; radial artery
Abstract
Recent studies have indicated that distal radial access (DRA) is feasible in patients undergoing percutaneous coronary intervention (PCI). The present study aimed to compare DRA, proximal radial access (PRA), and femoral access (FA) in patients with ST-elevation myocardial infarction (STEMI) undergoing PCI. Data were analyzed for 109 patients with STEMI treated via primary PCI from March 2020 to May 2021. The success rate of DRA was 83.3% (35/42), including seven cases of failed puncture (puncture failure = 5, severe radial artery spasm = 2). Primary PCI via the DRA was successful in all 35 patients. After classifying the patients requiring crossover into a separate group, the percentage of the puncture time in the door-to-wiring time was 2.7% [2.2-4.3], 3.3% [2.3-4.0], 2.6% [1.2-4.9], and 27.0% [13.5-29.3] in the DRA (n = 35), PRA (n = 24), FA (n = 26), and crossover (n = 9) groups, respectively (p < 0.01). Only two local hematomas (≤5 cm) occurred in the DRA group, while one patient in the FA group required surgical treatment and a transfusion for an access-site vascular injury. When performed by an experienced operator, DRA may represent a feasible alternative to other access routes in select patients with STEMI undergoing PCI, such as those with a high risk of bleeding.
Files in This Item:
T202103422.pdf Download
DOI
10.3390/jcm10153438
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yongcheol(김용철) ORCID logo https://orcid.org/0000-0001-5568-4161
Roh, Ji Woong(노지웅)
Son, Nak Hoon(손낙훈) ORCID logo https://orcid.org/0000-0002-6192-8852
Lee, Oh Hyun(이오현) ORCID logo https://orcid.org/0000-0001-7070-7720
Im, Eui(임의) ORCID logo https://orcid.org/0000-0002-5333-7593
Cho, Deok Kyu(조덕규)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184689
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