Adoption of Transradial Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction and Its Association with Door-To-Balloon Time

Abstract

Background: Access-site bleeding is the most frequent bleeding complication of transfemoral primary percutaneous coronary intervention (TF-PPCI). In contrast, transradial PPCI (TR-PPCI) has been demonstrated in multiple trials to be safer than the femoral approach due to the lower risk of significant bleeding. This study's objective was to study adoption of TR-PPCI for STEMI and its association with door-to-balloon time (D2BT). Methods: This study was carried out on 70 patients diagnosed as STEMI treated with PPCI were compared according to the access site used during the procedure. Patients were divided into 2 equal groups, group I: STEMI patients treated with TR-PPCI, and group II: STEMI patients treated with TF-PPCI. Patients were subjected to physical examination, risk assessment, electrocardiogram (ECG), transthoracic echocardiography, and coronary angioplasty. Results: D2BT was 107 min in TF-PPCI compared to 114 min in TF-PPCI group with no statistically significant difference. BMI and presence of prior peripheral arterial disease were significantly higher in TR-PPCI group compared to TF-PPCI group. Presence of cardiogenic shock and cardiac arrest within prior 24 h, and mean contrast volume were significantly lower in TR-PPCI group compared to TF-PPCI group (p ≤ 0.05). Clinical data, ECG, laboratory data, patients' presenting location, time in minutes, procedural medications, angiographic data, thrombus aspiration device, balloon angioplasty, direct stenting, number and type of stents, TIMI pre and post, and complications were insignificantly different between the studied groups. Conclusions: TR-PPCI can be successfully implemented without compromising D2BT performance offering the potential to improve STEMI outcomes if widely embraced.