Can a STEMI patient be managed via the radial in a timely manner?
The simple answer to this question is yes. Multiple groups have looked at their STEMI procedural times comparing the radial and femoral approach and the times are nearly equivalent. It is our feeling that the radial approach adds about 4 minutes to the lesion crossing time which is not likely to be clinically significant in most patients. Failed access and “crossover” to the femoral approach will occur more frequently than with the femoral approach, but with experience it should be less than 5% of cases. It is important to understand that most STEMI data is collected by experienced operators who know all the “tips and tricks.” Therefore, although clearly an emerging and important tool for STEMI management, TRI should not be the default approach until the physician is well along the learning curve.
