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Feasibility and effectiveness of distal radial access in ST-elevation myocardial infarction from a SPEEDY PCI subanalysis
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Feasibility and effectiveness of distal radial access in ST-elevation myocardial infarction from a SPEEDY PCI subanalysis
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Journal Article
Feasibility and effectiveness of distal radial access in ST-elevation myocardial infarction from a SPEEDY PCI subanalysis
2026
Overview
The distal radial approach (dTRA) is increasingly recognized as a viable alternative to the conventional radial approach in coronary interventions. However, its utility in ST-elevation myocardial infarction (STEMI)—where rapid revascularization is critical—remains underexplored. To evaluate the feasibility and procedural characteristics of dTRA in STEMI patients undergoing primary percutaneous coronary intervention (PCI), using a prespecified subanalysis of the SPEEDY PCI study. Among 370 STEMI patients enrolled, 63 underwent PCI via dTRA and 307 via the conventional radial approach. A propensity score–matched analysis was performed using Killip class, GRACE score, and door-to-sheath time as covariates. After matching, the dTRA group had significantly shorter sheath-to-balloon (12.5 ± 11.5 vs. 19.7 ± 11.7 min,
p
= 0.002) and door-to-balloon times (50.2 ± 25.9 vs. 62.3 ± 19.9 min,
p
= 0.007). Procedural success and 30-day mortality rates were comparable between groups. dTRA appears feasible and safe for STEMI patients in high-volume centers. While shorter time metrics were observed, these may reflect institutional practices and operator experience rather than the access site alone.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 692/4019
/ 692/699
/ Aged
/ Balloons
/ Consent
/ Female
/ Humanities and Social Sciences
/ Humans
/ Ischemia
/ Male
/ Patients
/ Percutaneous Coronary Intervention - methods
/ Primary percutaneous coronary intervention
/ Science
/ ST Elevation Myocardial Infarction - mortality
/ ST Elevation Myocardial Infarction - surgery
/ ST-Elevation myocardial infarction
/ Stroke
