RIFLE-STEACS Study Shows Benefits to Radial Approach in Primary PCI

Radial access should be the recommended approach in patients with ST-segment elevation acute coronary syndrome (STEACS) because of its significant clinical benefits, according to authors of a study published on Aug. 1 in the Journal of the American College of Cardiology.

The study, called RIFLE-STEACS, found the primary endpoint of 30-day net adverse clinical events occurred in 68 patients (13.6 percent) in the radial arm and 105 patients (21.0 percent) in the femoral arm (p _ 0.003). Specifically, radial access was associated with lower rates of cardiac mortality (5.2 percent vs. 9.2 percent, p = 0.020), bleeding (7.8 percent vs. 12.2 percent, p = 0.026), and shorter hospital stay (5 days first to third quartile range, 4 to 7 days] vs. 6 [range, 5 to 8 days]; p = 0.03). 


RIFLE-STEACS is the first large randomized clinical trial designed to compare the radial and femoral approaches for primary/rescue percutaneous coronary intervention (PCI). The results "demonstrate the advantage in terms of outcome of the radial over the femoral approach in STEACS patients," the authors said. However, they also cautioned that "specific transradial expertise to guarantee procedural time and a success rate comparable to those with the femoral approach are strongly recommended before using this technique in the emergency setting."

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