ABSTRACT
Objective To evaluate the clinical advantages of transradiai approach for percutaneous coronary intervention in elderly patients with acute myocardial infarction.Methods From January 2008 to October 2011,150 elderly patients (average age of 70.4±7.2 yrs) diagnosed with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary invention (PCI).They were divided into transfemoral intervention group (TFI group,n=91) and transradial intervention group (TRI group,n=59).The arrival time at the first balloon inflation,the success rate of reperfusion,the X ray exposure time,the total procedural time,contrast volume,the average in-hospital days,the mean hospital expenses and postoperative complications were compared between two groups.Results The average in-hospital days was shorter in TRI group than in TFI group [(9.3±0.5) days vs.(12.8±0.7) days,P＜0.01].The mean in-hospital expenses was less in TRIgroup than in TFI group [(44707.3±1009.3) RMB vs.(54047.8±1971.6) RMB,P＜0.05].There were no significant differences in the arrival time at the first balloon inflation,the success rate of reperfusion,the X-ray exposure time,the contrast volume between the two groups [(26.7±0.8)minutes vs.(27.7±1.2) minutes,98.3％ (58/59) vs.96.7％ (88/91),(10.8±0.9) minutes vs.(9.6±0.6) minutes,(223.9±9.2) ml vs.(229.8±7.5) ml,respectively,all P＞0.05].The postoperative complications including major bleeding,pseudoaneurysm,radial occlusion without ischemia and the incidence of major adverse cardiovascular events had no statistical differences between the two groups (P＞0.05).The cases of urethral catheterization caused by urinary retention were less in TRI group than in TFI (0 vs.11 cases,P＜0.01).Conclusions Compared with transfemoral approach,the transradial approach is feasible and safe for primary PCI in elderly patients with acute myocardial infarction,and has better clinical advantage and socioeconomic benefit.