A study found several benefits in using the radial artery in the arm as the entry point for angioplasty or percutaneous coronary intervention (PCI) compared to the femoral artery in the leg. Results of the STEMI-RADIAL trial were presented today at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.
Recent data have demonstrated better clinical outcomes in patients undergoing primary PCI by the radial approach compared to the femoral approach. However, the experience of operators with the radial approach in previous trials has been variable. In the STEMI-RADIAL trial, investigators examined the net clinical benefit of using the radial versus femoral approach in patients presenting within 12 hours of symptom onset of acute ST-elevation myocardial infarction (STEMI). All investigators were high-volume (>200 PCI/year) operators with significant experience in the radial approach (>80% cases/year).
STEMI-RADIAL was a randomized, national, multicenter, parallel group trial conducted in 707 patients at four high-volume centers. Patients eligible for both access sites without cardiogenic shock were randomized to the radial or femoral access approach. The primary endpoint was the cumulative incidence of major bleeding and vascular access site complications (requiring intervention) at 30 days. Secondary endpoints included major adverse cardiovascular events (MACE: death, reinfarction and stroke), technical success, access site failure, procedural and fluoroscopy times, contrast volume, intensive care stay and target lesion revascularization.