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

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) undergo...

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Autores principales: Lee, Oh-Hyun, Kim, Yongcheol, Son, Nak-Hoon, Roh, Ji Woong, Im, Eui, Cho, Deok-Kyu, Choi, Donghoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8348546/
https://www.ncbi.nlm.nih.gov/pubmed/34362221
http://dx.doi.org/10.3390/jcm10153438
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author Lee, Oh-Hyun
Kim, Yongcheol
Son, Nak-Hoon
Roh, Ji Woong
Im, Eui
Cho, Deok-Kyu
Choi, Donghoon
author_facet Lee, Oh-Hyun
Kim, Yongcheol
Son, Nak-Hoon
Roh, Ji Woong
Im, Eui
Cho, Deok-Kyu
Choi, Donghoon
author_sort Lee, Oh-Hyun
collection PubMed
description 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.
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spelling pubmed-83485462021-08-08 Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction Lee, Oh-Hyun Kim, Yongcheol Son, Nak-Hoon Roh, Ji Woong Im, Eui Cho, Deok-Kyu Choi, Donghoon J Clin Med Article 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. MDPI 2021-08-02 /pmc/articles/PMC8348546/ /pubmed/34362221 http://dx.doi.org/10.3390/jcm10153438 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Oh-Hyun
Kim, Yongcheol
Son, Nak-Hoon
Roh, Ji Woong
Im, Eui
Cho, Deok-Kyu
Choi, Donghoon
Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title_full Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title_fullStr Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title_full_unstemmed Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title_short Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
title_sort comparison of distal radial, proximal radial, and femoral access in patients with st-elevation myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8348546/
https://www.ncbi.nlm.nih.gov/pubmed/34362221
http://dx.doi.org/10.3390/jcm10153438
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