PMID- 20146306
OWN - NLM
STAT- MEDLINE
DCOM- 20100618
LR  - 20101118
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 75
IP  - 5
DP  - 2010 Apr 1
TI  - Arterial access and door-to-balloon times for primary percutaneous coronary 
      intervention in patients presenting with acute ST-elevation myocardial 
      infarction.
PG  - 695-9
LID - 10.1002/ccd.22373 [doi]
AB  - OBJECTIVES: This study compares the transradial versus the transfemoral approach 
      for time to intervention for patients presenting with ST elevation myocardial 
      infarction (STEMI). BACKGROUND: Survival following STEMI is associated with 
      reperfusion times (door-to-balloon; D2B). For patients undergoing primary PCI for 
      acute STEMI, potential effects of transradial approach (r-PCI) as compared with 
      the femoral artery approach (f-PCI) on D2B times have not been extensively 
      studied. METHODS: Consecutive patients presenting with STEMI at a tertiary care 
      medical center were enrolled in a comprehensive-Heart Alert program (HA) and 
      included in this analysis. Time parameters measured included: door-to-ECG, 
      ECG-to-HA activation, HA activation-to-cath lab team arrival, patient arrival in 
      cath lab to arterial access, and arterial access-to-balloon inflation. RESULTS: 
      Of 240 total patients, 205 underwent successful PCI (n = 124 r-PCI; n = 116 
      f-PCI). No significant difference was observed in the pre-cath lab times. Mean 
      case start times for r-PCI took significantly longer (12.5 +/- 5.4 min vs. 10.5 
      +/- 5.7 min, P = 0.005) due to patient preparation. Once arterial access was 
      obtained, balloon inflation occurred faster in the r-PCI group (18.3 vs. 24.1 
      min; P < 0.001). Total time from patient arrival to the cardiac cath lab to PCI 
      was reduced in the r-PCI as compared to the f-PCI group (28.4 vs. 32.7 min, P = 
      0.01). There was a small but statistical difference in D2B time (r-PCI 76.4 min 
      vs. f-PCI 86.5 min P = 0.008). CONCLUSIONS: Patients presenting with STEMI can 
      undergo successful PCI via radial artery approach without compromise in D2B times 
      as compared to femoral artery approach.
CI  - (c) 2009 Wiley-Liss, Inc.
FAU - Weaver, Aaron N
AU  - Weaver AN
AD  - Heart and Vascular Institute, Penn State University, Hershey Medical Center, 
      Hershey, Pennsylvania, USA. aweaver@hmc.psu.edu
FAU - Henderson, Rick A
AU  - Henderson RA
FAU - Gilchrist, Ian C
AU  - Gilchrist IC
FAU - Ettinger, Steven M
AU  - Ettinger SM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2010 Apr 1;75(5):700. PMID: 20333670
MH  - Academic Medical Centers
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/adverse effects/*methods/mortality
MH  - Chi-Square Distribution
MH  - Clinical Competence
MH  - Databases as Topic
MH  - Electrocardiography
MH  - *Emergency Medical Services
MH  - Female
MH  - *Femoral Artery
MH  - *Health Services Accessibility
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Prospective Studies
MH  - Quality of Health Care
MH  - *Radial Artery
MH  - Risk Assessment
MH  - Time Factors
MH  - *Transportation of Patients
MH  - Treatment Outcome
EDAT- 2010/02/11 06:00
MHDA- 2010/06/19 06:00
CRDT- 2010/02/11 06:00
PHST- 2010/02/11 06:00 [entrez]
PHST- 2010/02/11 06:00 [pubmed]
PHST- 2010/06/19 06:00 [medline]
AID - 10.1002/ccd.22373 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2010 Apr 1;75(5):695-9. doi: 10.1002/ccd.22373.