CathLab Digest

Does your cath lab do acute myocardial infarction patients via the radial approach, and does it interfere with the door-to-balloon time?

  Excellent question. At our facility, we prefer to do all ST-elevation myocardial infarctions (STEMIs) via the transradial approach. As you know, STEMIs represent a subset of patients in which revascularization is very time-sensitive issue and these patients often require potent adjunctive anticoagulation therapy. Therefore, they are at increased risk for bleeding complications, particularly of the access site. Data from clinical trials has demonstrated that the radial approach is associated with lower bleeding complications in all subsets of patients (Figure 1). In addition, bleeding increases mortality, which is why the transradial approach is the default method for the majority of our STEMIs.