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.
Highlights
From March 2020 to May 2021, we identified 109 consecutive patients who underwent primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI)
Among the seven cases of failed distal radial access (DRA), distal radial artery puncture failed in five patients, while sheath cannulation failed after successful puncture in two cases due to severe arterial spasms accompanied by pain
35, 25, and 34 patients were enrolled in the DRA, Proximal radial access (PRA), and femoral access (FA) groups for analysis, respectively
Summary
Received: 2 July 2021Accepted: 30 July 2021Published: 2 August 2021Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).Proximal radial access (PRA) for cardiac catheterization is associated with a better ability to achieve hemostasis, greater patient comfort, earlier ambulation, and shorter duration of hospitalization than femoral access (FA) [1]. Moreover, recent randomized trials and meta-analyses have demonstrated that PRA is associated with a reduced risk of access-site complications, major bleeding, and mortality in patients with acute coronary syndrome, when compared to FA [2,3,4,5]. Accordingly, current guidelines recommended
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
