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

nanoparticles, blood clotting, internal bleeding, American Chemical Society study, Erin B. Lavik

Nanoparticles (green) help form clots in an injured liver. The researchers added color to the scanning electron microscopy image after it was taken. Image courtesy of Erin Lavik, Ph.D.

News | Hemostasis Management| August 24, 2016
August 24, 2016 — Whether severe trauma occurs on the battlefield or the highway, saving lives often comes down to...
Intact Vascular, TOBA clinical study, one-year results, Tack Endovascular System, Journal of Vascular Surgery
News | Peripheral Arterial Disease (PAD)| August 24, 2016
Intact Vascular Inc. announced that the one-year results from its Tack Optimized Balloon Angioplasty (TOBA) clinical...
Technavio report, renal denervation devices, 2015
News | Renal Denervation| August 23, 2016
August 23, 2016 — Technavio analysts forecast the global...
News | Heart Failure| August 23, 2016
August 23, 2016 — A new study of more than 13,000 people has found that so-called morbid obesity appears to stand alo
Jason Burdick, injectable hydrogels, heart failure, heart attack, American Chemical Society

Compared to other types of hydrogels being developed (left), a new hydrogel (right) can form crosslinks after injection into the heart, making the material stiffer and longer-lasting. Image courtesy of American Chemical Society.

News | Heart Failure| August 23, 2016
August 23, 2016 — During a heart attack, clots or narrowed arteries block blood flow, harming or killing cells within
News | Peripheral Arterial Disease (PAD)| August 22, 2016
Avinger Inc. recently announced the closing of its previously announced public offering of 9,857,800 shares of Avinger’...
sleep apnea, hypertension, clinical study, Science Signaling, University of Chicago
News | Hypertension| August 22, 2016
Obstructive sleep apnea is a common cause of high blood pressure. In the Aug. 17, 2016, issue of the journal Science...
DMC Heart Hospital, Detroit Medical Center, complex percutaneous intervention education course, PCI, cath lab training
News | Cath Lab| August 22, 2016
The Detroit Medical Center (DMC) Heart Hospital recently completed a Complex Percutaneous Intervention education course...
TAILOR-PCI study, antiplatelet medication, genotype, NHLBI grant
News | Antiplatelet and Anticoagulation Therapies| August 18, 2016
Researchers at the Peter Munk Cardiac Centre, Toronto, and at Mayo Clinic are leading the Tailored Antiplatelet Therapy...
Covidien, Medtronic, TurboHawk, Atherectomy system

The Medtronic TurboHawk atherectomy system. 

Feature | Atherectomy Devices| August 18, 2016 | Dave Fornell
Due to poor outcomes from percutaneous transluminal angioplasty (PTA) ballooning of vessels alone, or of stenting in
Overlay Init