Adoption of Transradial Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction and Its Association with Door-To-Balloon Time

Zahran, Mostafa; El Rabat, Khaled Emad; Abd El Rahman, Yaser Hosney; Abd El Mageed, Ashraf Ahmed; El Nagar, Amr El Sayed

doi:10.21608/bmfj.2023.218914.1843

Adoption of Transradial Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction and Its Association with Door-To-Balloon Time

Document Type : Original Article

Authors

¹ Department of cardiovascular medicine, National Heart Institute

² Professor of Cardiology, Faculty of Medicine, Benha University

³ Cardiology department, Benha Faculty of Medicine, Benha University

⁴ Consultant of Cardiology, National Heart Institute, Giza

⁵ Lecturer of Cardiology Faculty of Medicine - Benha University

10.21608/bmfj.2023.218914.1843

Abstract

Background: Access-site bleeding is the most frequent bleeding complication of transfemoral primary percutaneous coronary intervention (TF-PPCI). In contrast, transradial PPCI (TR-PPCI) has been demonstrated in multiple trials to be safer than the femoral approach due to the lower risk of significant bleeding. This study's objective was to study adoption of TR-PPCI for ST elevation myocardial infarction (STEMI) and its association with door‐to‐balloon time (D2BT). Methods: This study was carried out on 70 patients diagnosed as STEMI treated with PPCI were compared according to the access site used during the procedure. Patients were divided into 2 equal groups, group I: STEMI patients treated with TR-PPCI, and group II: STEMI patients treated with TF-PPCI. Patients were subjected to physical examination, risk assessment, electrocardiogram (ECG), transthoracic echocardiography, and coronary angioplasty. Results: D2BT was 107 min in TF-PPCI compared to 114 min in TF-PPCI group with no significant statistical difference. BMI and presence of prior peripheral arterial disease were significantly higher in TR-PPCI group compared to TF-PPCI group. Presence of cardiogenic shock and cardiac arrest within prior 24 h, and mean contrast volume were significantly lower in TR-PPCI Group compared to TF-PPCI Group (P ≤ 0.05). Clinical data, ECG, laboratory data, the patients’ presenting location, time in minutes, procedural medications, angiographic data, thrombus aspiration device, balloon angioplasty, direct stenting, number and type of stents, Conclusions: TR-PPCI can be successfully implemented without compromising D2BT performance offering the potential to improve STEMI outcomes if widely embraced.

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