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Access site selection for primary PCI: the evidence for transradial access is strong
  1. Karim Ratib1,
  2. Mamas A Mamas2,
  3. Helen Routledge3,
  4. Douglas Fraser2,
  5. James Nolan1
  1. 1Cardiology Department, University Hospital of North Staffordshire, Stoke-on-Trent, UK
  2. 2Manchester Royal Infirmary, Manchester, UK
  3. 3Royal Worcestershire Hospitals, Worcester, UK
  1. Correspondence to Dr Karim Ratib, Cardiology Department, University Hospital of North Staffordshire, Stoke-on-Trent, ST4 6QF, UK; kratib{at}

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To the Editor: We were interested to read the editorial written by Meier et al1 relating to our recent meta-analysis of randomised trials evaluating access site selection in ST-elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI).2 We agree with their comment that our meta-analysis adds to the body of evidence in support of radial access, and that our analysis has to be considered in the light of a number of interrelated issues. We do not however agree with the interpretation of several points discussed in the editorial.

Meier et al state that radial access is used in only 35% of PCI cases in the UK. In fact, the data on access site utilisation in 2010 from the British Cardiovascular Intervention Society (BCIS) database indicates that the majority (51%) of all UK PCI is now performed via radial access.3 This has increased rapidly over the last 6 years, from just 10% in 2004. This rapid evolution in practice reflects a growing consensus among UK operators that radial access has important …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.