Trial finds benefits to using radial versus femoral access for primary angioplasty in heart attack patients

OCTOBER 26, 2012 – 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 of acute ST-elevation (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.

The primary endpoint of major bleeding or access site complications occurred in 7.2 percent of the femoral access patients and 1.4 percent of the radial access patients (p=0.0001). The rate of MACE at 30 days was 4.2 percent in the femoral access group, and 3.5 percent in the radial access group (p=0.7).

"In patients with STEMI undergoing PCI within 12 hours, the radial approach was associated with a significantly lower incidence of major bleeding and access site complications, resulting in a significantly better net clinical benefit," said lead investigator Ivo Bernat, MD, PhD. Dr Bernat is an Assistant Professor of Medicine at University Hospital Pilsen in the Czech Republic.

"Moreover, the radial approach reduced significantly ICU stays and contrast volume compared to the femoral approach. Results of this trial support the use of the radial approach in primary PCI in high volume centers as a first choice," Dr. Bernat said.

The results of the STEMI-RADIAL trial will be presented on Friday October 26, 2012 at 11:55 AM in the Main Arena (Hall D) of the Miami Beach Convention Center.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Cerebrovascular reserve-based strategy is cost-effective

Jan 29, 2015

(HealthDay)—A decision rule based on assessment of cerebrovascular reserve (CVR) seems to be cost-effective for prevention of stroke in asymptomatic patients with carotid artery stenosis, according to a ...

New hypertension guidelines could save lives and money

Jan 28, 2015

Full implementation of new hypertension guidelines could prevent 56,000 cardiovascular disease events (mostly heart attacks and strokes) and 13,000 deaths each year, without increasing overall health care costs, an analysis ...

Manchester United's rising stars revolutionize heart health

Jan 28, 2015

A unique research project to identify the effects of exercise on young hearts has been announced today [Wednesday 28 January 2015]. Manchester United's Academy players are being put through their paces having their hearts ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.