RIVAL trial - Summary & Results

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A head-to-head comparison of Radial vs Femoral Access for Coronary Intervention (RIVAL)

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RIVAL trial - Summary & Results

  1. 1. RIVAL: Radial vs Femoral Access forCoronary Intervention
  2. 2. RIVAL: Radial vs Femoral Access for CoronaryInterventionS Jolly (McMaster University, Hamilton, ON)American College of Cardiology 2011 Scientific Sessions• A head-to-head comparison of radial vs femoral access for the treatment of patients with acute coronary syndromes (ACS)• Population and treatment: 7021 ACS patients with and without ST-segment elevation An invasive treatment option was planned (radial or femoral) by an interventional cardiologist who had performed a minimum of 50 radial procedures for coronary angiography or interventions in the last year• Outcomes (at 30 days): Primary end point: A composite of death, MI, stroke, or non-CABG-related major bleeding Secondary end points: Included death, MI, or stroke
  3. 3. RIVAL: ResultsOverall cohort:• There was no significant difference shown in the incidence of the primary outcome at 30 days between the groups (3.7% for radial access vs 4.0% for femoral access)• Secondary end points, including death, MI, or stroke, also showed no significant difference• Non-CABG major bleeding at 30 days was also similar between the two groupsSTEMI subgroup:• Radial access led to statistically significant improvements in STEMI patients: 40% relative reduction in the risk of death, MI, stroke, or non-CABG-related major bleeding 61% relative reduction in the risk of death
  4. 4. RIVAL: Commentary*"Interventional cardiologists should feel reassured that both radial and femoralprocedures are safe and effective in the current era." - Dr Sanjit Jolly"I think the RIVAL trial is consistent with most peoples practices and experiences,and I dont think the data in and of itself will change practice." - Dr Gregg Stone"There is going to be an increase in radial cases in the United States. . . . There willbe patient preference, and a lot of the young operators wanting to get moreexperience." - Dr Martin Leon*All comments from Radial RIVALs femoral access for invasive ACS treatment, but doesnt beat it(http://www.theheart.org/article/1205267.do)
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