Mechanisms by Which Transradial Approach May Reduce Mortality in ST-Segment–Elevation Myocardial Infarction

12-Month Clinical Follow-Up of Patients Undergoing Early Invasive Strategy by the Transradial or Transfemoral Approach with Vascular Closure Device

“…No differences were observed between the techniques regarding the incidence of vascular complications at 30 days and serious adverse cardiovascular events at 12 months. In fact, it is postulated that the benefits derived from the radial technique are mainly due to the reduction in the prevalence of severe bleeding and the need for blood transfusion, 17 which was not observed in our study. Our findings differ from the few publications comparing the radial access to VOD, where the first is associated with a significant reduction of vascular complications, as the main difference …”

Insucesso da Técnica Radial em Centro com Alto Volume de Procedimentos

“…9 Thus, the most consistent benefits are demonstrated in patients undergoing primary PCI, commonly treated with aggressive antithrombotic pharmacotherapy and exposed to higher risks. 10,11 However, consensuses about this topic reinforce the importance of procedures performed by experienced operating physicians, with low percentage of failure of the technique (less than 4%), so that the technical difficulties do not result in a delayed reperfusion of the target vessel.…”

Vascular access: time development and contemporary practice

“…The adverse prognostic effect of major bleeding after PCI procedure, mainly for patients presenting acute coronary syndrome, has been highlighted in the past decade in large trials, such as ACUITY, showing a similar negative impact of major bleeding and re-infarction during 1-year follow-up. 21 Approximately two-thirds of bleedings were attributed to puncture site complications, [22][23][24] and once vascular complications are reduced, one might infer that using the radial access would promote concomitant reduction of ischemic events and mortality (Figure 4). dies in acute myocardial infarction settings, such as the RIFLE-STEACS study, which also supported the use of the transradial access, by showing a 47% decrease in bleeding events when compared to the transfemoral access, having a direct prognostic impact on the 30-day combined events rate.…”