INTERVENTIONAL CARDIOLOGY

Randomised comparison of femoral versus radial approach for percutaneous coronary intervention using abciximab in acute myocardial infarction: results of the FARMI Trial

Camille Brasselet¹, Sophie Tassan¹, Pierre Nazeyrollas¹, Martial Hamon², Damien Metz¹

¹ Department of Cardiology, Centre Hospitalier Universitaire Robert Debré, Reims Cedex, France
² Service des Maladies du Coeur et Vaisseaux, Centre Hospitalier Universitaire, Caen Cedex, France

Dr C Brasselet, Department of Cardiology, CHU Robert Debré, Avenue du général Koenig, 51092 Reims Cedex, France; camille.brasselet{at}wanadoo.fr

Objective: To compare bleeding complications and results of percutaneous coronary intervention (PCI) between patients treated by radial and femoral approaches for acute myocardial infarction (AMI,) and using abciximab and 5 French guiding-catheters.

Patients: 114 consecutive patients with AMI were prospectively randomised. Exclusion criteria were a history of coronary artery bypass graft, cardiogenic shock, atrioventricular block, and contraindication to abciximab or a negative Allen test. Local haemostasis was achieved by manual compression.

Results: Baseline characteristics were similar between the two groups. Peripheral arterial complication rates and delays to patient ambulation were significantly lower in the radial group than in the femoral group, whereas in-hospital stay was similar between the two groups. A cross over was more often necessary in the radial group than in the femoral group. Coronary angiography duration and fluoroscopy time were significantly longer in the radial group than in the femoral group, whereas PCI duration was similar in both groups.

Conclusions: The FARMI trial showed that the radial route lowered peripheral arterial complication rates and allowed earlier ambulation, despite no significant benefit on the duration of hospitalisation.

Abbreviations: AMI, acute myocardial infarction; FARMI, Five French Arterial access with Reopro in Myocardial Infarction (trial); Gp, glycoprotein; PCI, percutaneous coronary intervention; TIMI, thrombolysis in myocardial infarction

Keywords: GpIIb/IIIa antagonist; percutaneous coronary intervention; acute myocardial infarction; radial

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