Comparative study on transradial approach vs. transfemoral approach in primary stent implantation for patients with acute myocardial infarction: Results of the test for myocardial infarction by prospective unicenter randomization for access sites (TEMPURA) trial

Abstract

Transradial coronary intervention (TRI) can be performed in elective patients with low incidence of access site complications. However, the feasibility of primary stent implantation by TRI is still not clear in patients with acute myocardial infarction (AMI). We prospectively randomized 149 patients out of 213 patients with AMI within 12 hr from onset into two groups: 77 patients treated by TRI (TRI group) and 72 patients by transfemoral coronary intervention (TFI; TFI group). We compared the incidences of major adverse cardiac events (MACE; repeat MI, target lesion revascularization, and cardiac death) during the initial hospitalization and 9-month follow-up periods in both groups. There were one patient who crossed over to the opposite arm, and two patients with severe bleeding complications in the TFI group. Background characteristics of patients were similar between the two groups. The success rate of reperfusion and the incidence of in-hospital MACE were similar in both groups (96.1% and 5.2% vs. 97.1% and 8.3% in TRI and TFI groups, respectively). In selected patients with AMI, primary stent implantation by TRI is feasible as compared to TFI.

Safety and Efficacy of Transradial vs Transfemoral Arterial Primary Coronary Angioplasty for Acute Myocardial Infarction Single-Center Experience

“…To the best of our knowledge, Saito et al 26 were the pioneers in comparing the safety and feasibility of the TRA and TFA approaches for patients with AMI undergoing primary PCI. Their results demonstrated that for selective patients with AMI, the TRA is comparable to the TFA in terms of the success rate of reperfusion and the incidence of in-hospital major adverse clinical events.…”

Radial artery ultrasound predicts the success of transradial coronary angiography

“…Furthermore, the indications for TRA have expanded to include the pPCI and treatment of complex lesions, such as those occurring at bifurcations and those creating total occlusion [15][16][17]. The most frequent complication after TRA is RAO; its incidence of around 5% may be higher for smaller RADs [8,12].…”

Transradial Approach for Coronary Interventions: The New Gold Standard for Vascular Access?

“…Randomized trials performed after 2000 do not advocate this point when procedural success is compared to those reported for transfemoral PCI studies, especially when dedicated radial materials are used (2,11,37,57 As with the femoral approach, the ideal sizing and shape of guiding catheters is still, and will stay a matter for debate.…”