ST Elevation Myocardial Infarction
Conditions
Keywords
Distal radial access, Snuffbox approach, ST Elevation Myocardial Infarction
Brief summary
Distal radial access (DRA) has recently introduced and previous studies have demonstrated that it is feasible option, showing several advantages including less bleeding and access-site complications over proximal radial access (PRA). Previous study reported the feasibility of DRA as an alternative option for primary percutaneous coronary intervention (PCI) in STEMI patients without major complication. However, comparison study of each vascular access for primary PCI have not been conducted until now. Here, The investigators aim to compare the DRA, PRA and femoral access (FA), in terms of feasibility and safety, in patients with STEMI. This is a retrospective study with patients who underwent primary PCI for STEMI between March 2020 to May 2021. The primary outcome of this study is the access-site complication including major bleeding requiring transfusion or surgery, hematoma and arterial occlusion.
Detailed description
Recently, DRA has gained the interest of interventional cardiologists and previous studies have demonstrated several advantages including patient and operator comfort, shorter hemostasis duration, less bleeding, and access-site complications over PRA. More recently, randomized trial demonstrated that DRA prevents radial artery occlusion after the procedure compared with PRA. From this perspective, DRA could be considered an alternative access route for primary PCI in selected STEMI patients using potent P2Y12 inhibitors such as ticagrelor or prasugrel, or glycoprotein IIb/IIIa inhibitors.
Interventions
PROCEDUREDistal radial access
Vascular access for primary PCI in patients with STEMI
Sponsors
Yonsei University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Between March 2020 to May 2021, patients who underwent primary PCI for STEMI at the Yongin Severance Hospital
Exclusion criteria
* Refractory cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| access-site complication | 1 month | puncture site related complication |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The success rate of the primary PCI | Through procedure | Success rate (%) = Successful primary PCI / All PCI procedures |
| The success rate of the puncture | Through procedure | The success rate (%) of vascular puncture |
| The percentage of puncture time in Door-to-wiring time (%) | Through procedure | Puncture time = time interval from local anesthesia induction to successful sheath cannulation. Door-to-wiring time = time elapsed from arrival of patient at the emergency department to guide wire passage through the lesion. |
Countries
South Korea
Outcome results
None listed