Recommendation ID
CG167/3
Question
Radial arterial access primary PCI versus femoral arterial access primary PCI:- What is the clinical and cost effectiveness of radial arterial access compared with femoral arterial access for coronary angiography or primary PCI in people with acute STEMI managed by primary PCI?
Any explanatory notes
(if applicable)
Why this is important:- There is no current evidence that demonstrates if there is a mortality difference between radial arterial access primary PCI compared with femoral arterial access primary PCI. It is unclear if operator experience has influenced current evidence. Operators may need additional training if 1 approach was shown to be superior. A randomised controlled trial comparing the 2 interventions for longer-term outcomes of all-cause mortality and major adverse cardiovascular events would answer the question. The trial would need to address the impact of operator expertise on the clinical outcomes. In addition, the need for operator training could be informed by an observational study that looked at the effectiveness and impact on clinical outcomes of experienced radial operators primarily using the radial approach versus experienced femoral operators primarily using the femoral approach including closure devices. The study would need a sufficient number of participants to enable differences in outcomes to be detected.

Source guidance details

Comes from guidance
Myocardial infarction with ST-segment elevation: acute management
Number
CG167
Date issued
July 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/07/2013