RADIal versus femoral approach for percutaneous coronary interventions in patients with Acute Myocardial Infarction (RADIAMI): A prospective, randomized, single-center clinical trial.

Background: The transradial approach for percutaneous coronary intervention (PCI) seems to be superior to transfemoral. The safety and efficacy of transradial approach for PCI in acute myocardial infarction is not well-established. Methods: Hundred patients with acute myocardial infarction qualified to PCI were randomly assigned to transradial (group I; n = 50) and transfemoral (group II; n = 50) approaches. Results: PCI was successful for almost all patients, except one from group II. There were no significant differences between groups in X-ray exposition, volume of contrast and total procedure duration. Small but significant elongation of door to stent time in group I was caused mostly by a longer time between beginning of procedure and arterial sheath introduction. Major bleeding complications occurred in three patients from group I and seven from group II. There were no significant differences observed between the two groups. Time to ambulation in group I was significantly shorter then in group II (22.6 +/- 10.3 h vs. 34.7 +/- 34.6 h; p = 0.003). Conclusions: The transradial approach for PCI in acute myocardial infarction has the same efficacy as transfemoral. There are no differences in total procedure duration, X-ray exposition or volume of contrast between the two approaches. A longer time from the patient's admission to the individual stages of the PCI procedure in group I was mostly due to the longer times of the initial stages of the procedure. The use of transradial approach reduces the time to ambulation and allows rehabilitation to begin sooner. In both groups, bleeding complications occurred rarely.