Guideline recommended door-to-balloon time can be achieved in transradial primary PCI — the usefulness of a dedicated radial guide catheter

• Published in: Cardiovascular revascularization medicine Vol. 14; no. 1; pp. 27 - 31
• Main Authors: Malaiapan, Yuvaraj, Leung, Michael, Ahmar, Walid, Hutchison, Adam W, Prasad, Sandhir, Katticaran, Therma, Cameron, James D, Harper, Richard W, Meredith, Ian T
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2013
• Subjects: Aged; Angioplasty; Cardiac Catheters; Cardiovascular; Chi-Square Distribution; Equipment Design; Female; Femoral Artery; Guideline Adherence; Humans; Male; Medical Audit; Middle Aged; Myocardial Infarction - therapy; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - methods; Percutaneous Coronary Intervention - standards; Practice Guidelines as Topic; Program Evaluation; Radial Artery; Retrospective Studies; ST-elevation myocardial infarction; Time Factors; Time-to-Treatment; Treatment Outcome; Angioplasty; ST-elevation myocardial infarction
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2012.10.012

Abstract Background Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However , there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access. Aims To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI. To determine the impact of a single dedicated radial guide catheter on CCLD2BT and D2BT in transradial PPCI compared to conventional transfemoral PPCI. Methods The procedural and clinical outcomes of consecutive patients who had transradial primary PCI between 2005 and 2009 were included in this study and compared with a matched cohort who underwent transfemoral primary PCI. Results Overall D2BT and inpatient MACE were similar between the radial (n = 53) and femoral (n = 53) groups (85 and 82 min, P = 0.889; 0% and 1.8% P = 0.317 respectively). An increase in the CCL2BT and procedural times was noted in the radial compared to the femoral group (34 min versus 29 min P = 0.028; 15.8 min versus 11.6 min P = 0.001). When a single radial guide catheter was used for the entire procedure, there was no difference in CCL2BT, D2BT and procedural times between the radial and femoral groups (31 min versus 29 min P = 0.599; 74 min versus 82 min P = 0.418; 50 min versus 47 min P = 0.086). Conclusion The radial approach is safe and results in guideline recommended D2BT in STEMI. The use of a dedicated radial guide catheter reduces treatment time, demonstrating equivalent times to a femoral approach.