RADIal versus femoral approach for percutaneous coronary interventions in patients with Acute Myocardial Infarction (RADIAMI): A prospective, randomized, single-center clinical trial
Background: The transradial approach for percutaneous coronary intervention (PCI) seems
to be superior to transfemoral. The safety and efficacy of transradial approach for PCI in acute
myocardial infarction is not well-established.
Methods: Hundred patients with acute myocardial infarction qualified to PCI were randomly
assigned to transradial (group I; n = 50) and transfemoral (group II; n = 50) approaches.
Results: PCI was successful for almost all patients, except one from group II. There were no
significant differences between groups in X-ray exposition, volume of contrast and total procedure
duration. Small but significant elongation of door to stent time in group I was caused
mostly by a longer time between beginning of procedure and arterial sheath introduction.
Major bleeding complications occurred in three patients from group I and seven from group II.
There were no significant differences observed between the two groups. Time to ambulation in
group I was significantly shorter then in group II (22.6 ± 10.3 h vs. 34.7 ± 34.6 h; p = 0.003).
Conclusions: The transradial approach for PCI in acute myocardial infarction has the same
efficacy as transfemoral. There are no differences in total procedure duration, X-ray exposition
or volume of contrast between the two approaches. A longer time from the patient’s admission
to the individual stages of the PCI procedure in group I was mostly due to the longer times of
the initial stages of the procedure. The use of transradial approach reduces the time to ambulation
and allows rehabilitation to begin sooner. In both groups, bleeding complications occurred
rarely