Radial access PCI best for acute coronary syndrome patients

March 15, 2018|Cardiology

REPORTING FROM THE 2018 CRT MEETING

Dr. Omerovic claimed that the key message is that “there should be more radial access performed in the United States.” The 90% radial access in this study is reflective of current practice in Sweden and most other European countries, according to Dr. Omerovic. In contrast, the U.S. rate is closer to 60% by some estimates.

Several U.S. interventionalists on the session panel were not convinced that the VALIDATE-SWEDEHEART data establish superiority for radial access. According to Cindy Grines, MD, chair of cardiology at Hofstra Northwell School of Medicine in Hempstead, N.Y., it is not possible to control for all confounders, and the femoral access patients in this study were an “ultrahigh-risk” group. Just as importantly, she questioned whether fair comparisons could be made in a setting where 90% of interventions are performed by radial access.

“I would always be concerned that if you are performing radial access 90% of the time, you are going to lose your femoral skills,” Dr. Grines said. Like other U.S. interventionalists who commented during an animated discussion, she insisted that a prospective randomized trial, not a subgroup analysis, is needed before declaring radial access preferred.

Dr. Omerovic reports financial relationships with AstraZeneca, Bayer, and Boston Scientific.

SOURCE: Omerovic E. CRT 2018.