• Zbigniew Siudak, Barbara Zawislak, Artur Dziewierz, Tomasz Rakowski, Jacek Jakala, Stanislaw Bartus, Beata Noworolnik, Wojciech Zasada, Jacek S Dubiel, and Dariusz Dudek.
• Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland.
• Coron. Artery Dis. 2010 Aug 1; 21 (5): 292-7.

ObjectivesOur aim was to investigate the safety and efficacy of transradial approach, predictors of bleeding complications, and choice of radial access site in a real-life setting using a contemporary European registry of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI).BackgroundThere is an increasing amount of data suggesting that transradial approach is associated with less bleeding at access site and other vascular complications when compared with procedures carried out through the femoral artery.MethodsConsecutive data on STEMI patients transferred for primary PCI in hospital STEMI networks between November 2005 and January 2007 from seven countries in Europe were gathered. Patients were divided into the following two groups: radial approach - with radial access site for primary PCI, and transfemoral approach (FEM) - with femoral access site.ResultsData from a total of 1650 patients were collected in the EUROTRANSFER Registry. Abciximab was administered in 1086 patients (66%), 169 patients were assigned to radial approach group, whereas 917 to FEM group. Puncture site hematomas were more frequent in the FEM group (1.2 vs. 9.4%, P<0.001). Major bleedings requiring blood transfusion occurred similarly in both the studied groups. Independent predictors of bleeding (puncture site hematoma and major bleeding requiring transfusion) included female sex, lower weight, chronic renal failure, past stroke, and femoral access site (odds ratio=3.54).ConclusionThe choice of radial access site in patients with STEMI treated with primary PCI is associated with lower local bleeding complications like puncture site hematomas and is an independent predictor of fewer bleedings.

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