Feature | November 06, 2012

Trial Finds Benefits Using Radial vs. Femoral Access in STEMI

Results of the STEMI-RADIAL trial presented at TCT 2012

November 6, 2012 — A study has 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 at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation.

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 symptom onset of acute ST-elevation myocardial infarction (STEMI). All investigators were high-volume (>200 PCI/year) operators with significant experience in the radial approach (>80 percent 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, M.D., Ph.D., 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.“

The trial was supported by the Charles University Research Fund, and was a project of the Ministry of Health, Czech Republic for development of University Hospital Pilsen. Bernat reported no financial conflicts of interest.

For more information: www.crf.org

Related Content

Avinger, U.S. Department of Veterans Affairs, VA, Lumivascular technology, FSS Contract Award
News | Optical Coherence Tomography (OCT)| September 27, 2016
Avinger Inc. recently announced the company has received an FSS Contract Award from the U.S. Department of Veterans...
News | Pharmaceuticals| September 26, 2016
Nearly 2 out of 5 people with diabetes who could benefit from statin therapy to lower their risk of future heart attack...
Bard, Lutonix 014 DCB, drug-coated balloon, six-month endpoint, FDA IDE trial
Technology | Drug-Eluting Balloons| September 26, 2016
C. R. Bard Inc. announced the U.S. Food and Drug Administration (FDA) approved an Investigational Device Exemption (IDE...
smartphones, hospital tranfers, heart attack patients, JACC study, South Korea
News | Mobile Devices| September 23, 2016
Smartphone communication among medical teams at different hospitals can significantly reduce the time it takes for...
Robert M. Califf, FDA commissioner, future of cardiovascular medicine, JACC column
News | Business| September 23, 2016
Technology advances coupled with increased use of social media and personal devices could offer new possibilities for...
Medtronic, In.Pact Admiral drug-coated balloon, trial data, VIVA
News | Drug-Eluting Balloons| September 22, 2016
New data presented at the Vascular Interventional Advances (VIVA) conference demonstrated the durability, consistency...
4Tech, TriCinch TTVR, transcather tricuspid valve repair device, first implant
News | Heart Valve Technology| September 22, 2016
4Tech Inc. announced that its TriCinch device has been used in the world’s first-ever successful transcatheter...
Transesophageal Echo, TEE. Interventional echocardiography, interventional echo, Philips, CX50

Transesophageal echo (TEE) has become an essential part of the new transcatheter structrual heart therapies, giving rise to a new sub-speciality of interventional echocardiography.  

Feature | Cath Lab Navigation Aids| September 21, 2016 | Dave Fornell
The rapid growth of transcatheter structural heart procedures and the need for increased use of echocardiography as a
Sponsored Content | Videos | Inventory Management| September 21, 2016
With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient
Claret Medical, Sentinal CPS, cerebral protection system, FDA marketing application, TAVR, embolic protection
News | Embolic Protection Devices| September 20, 2016
Claret Medical announced its filing of a marketing application with the U.S. Food and Drug Administration (FDA) for...
Overlay Init