ISSN : 2146-3123
E-ISSN : 2146-3131

Left Distal Radial Artery Access Site in Primary Percutaneous Coronary Intervention: Is It Safe?
Elton Soydan1, Mustafa Akın1
1Department of Cardiology, Ege University School of Medical, İzmir Turkey
DOI : 10.4274/balkanmedj.galenos.2020.2020.4.49

Background: Left distal radial artery (LDRA) access site has emerged as a new technique for coronary angiography procedures.
Aims: We aimed to assess its applicability as an alternative way for primary percutaneous coronary interventions in ST-Elevation Myocardial Infarction (STEMI).
Study Design: This study was a retrospective evaluation of consecutive STEMI patients intervened through the left distal radial artery access site.
Material and Methods: Left distal radial artery was used as an access site in consecutive 30 STEMI patients for primary coronary intervention. It was used by experienced operators and unaware of the study. All patients had a prominent pulse in their left forearm and distal radial artery. Each patient's left arm was gently bent into his/her right groin with comfortable position of the hand. The operator/s stood at the right side of the patient where he/they could make the arterial puncture. Demographic features and complications were recorded during the hospital stay.
Results: Mean age of patients was 58 years with a male gender predominance of 87%. Fifteen patients were diagnosed with Inferior STEMI followed by 14 patients with Anterior and one with Lateral STEMI. The most common culprit artery was the left anterior descending coronary artery (14 patients). Six patients were in KİLLİP class II on admission and only one with Anterior STEMI was in severe pulmonary edema (KILLIP III) during intervention. All the procedures were successfully contemplated with 6 French Judkins catheters. Brachial spasm occurred in one patient which resolved with intra-arterial nitrate. Transfemoral approach was changed to LDR access in 4 patients due to severe bilateral iliac artery disease. Mean puncture time was 37.36 seconds. There were no radial occlusion, hematoma, hand neurologic deficit or bleeding. Patients were discharged in a mean time of 4.2 days.
Conclusion: Left distal radial artery can be used as an alternative safe and feasible access site for successful primary coronary interventions provided that it is performed by experienced operators.

Keywords : Acute myocardial infarction, left distal artery, primary percutaneous intervention

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