Trans-radial primary percutaneous coronary intervention in ST-elevation myocardial infarction

ABSTRACT

To study the effect of trans-radial approach [TRA] on achievement of a door-to-balloon time [DBT] of percutaneous coronary intervention [PPCI] for ST-elevation myocardial infarction [STEMI]. Case series. Armed Forces Institute of Cardiology - National Institute of Heart Diseases [AFIC -NIHD], Rawalpindi, from October 2011 to August 2012. Systems goal for door-to-balloon time [DBT - time elapsed between first medical contact and restoration of flow in the infarct related artery [IRA]] was set at < 90 minutes. Procedural success was defined as restoration of TIMI 3 flow in the IRA with less than 30% residual stenosis and discharge from hospital. Non-infarct related arteries were not treated. Bleeding episodes were defined by TIMI definitions. For vascular access for PPCI in a total of 207 patients, TRA was 91.3% [n = 189], transfemoral approach [TFA] 6.3% [n = 13] and brachial 2.4% [n = 5]. Males represented 90.3% of cases and 7% were females. Mean age was 55 +/- 10.86 years. Procedural success rate was 97.1%. Mean DBT was 54.1 minutes. DBT was less patients respectively. DBT patients. The difference in DBT between the different access groups was not markedly different between the three groups. There were 6 [2.9%] in-hospital deaths and no major bleeds. TRA for PPCI poses no hindrance to achieving a DBT of < 90 minutes in PPCI for STEMI. Furthermore, the in-hospital mortality rates are acceptable and within rational limits