الفهرس 
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Abstract
Background:
The radial approach has been increasingly used as an alternative to femoral access as it improves patients comfort; associated with less access site complications (local ischemia, large hematoma, minor or major hemorrhagic complications) and permits earlier ambulation and discharge.
Aim of the work:
Our aim was to assess the feasibility, and safety of trans-radial approach (TRA) versus trans-femoral approach (TFA) for percutaneous coronary intervention in acute STEMI patients.
Patients and Methods:
The study included seventy patients (35 patients in the radial approach group and 35 patients in the femoral approach group).
Patients with any contraindication to one of both approaches were excluded.
Results:
There was no significant differences between both groups regarding risk factors: smoking (60.0%) and (65.7%) respectively followed by dyslipidemia (57.1%) and (54.3%) respectively followed by hypertension and diabetes then finally positive family history.
There was no statistical significance difference between two groups regarding procedure and access success.
Failure rate was two cases which represents (5.8%) of patients studied in femoral group , two case failed due to tortuosity while failure rate were four cases which represents (11.4%) of patients studied in radial group, first and second cases failed due to spasm, the third case failed puncture and the fourth case due to failed cannulation of coronary artery.
We noticed that bleeding complications including (ecchymosis and hematoma) were higher in trans femoral than trans radial group with P= 0.5).
Because the radial artery is superficial and easily compressible, so achieved adequate hemostasis with a pressure device or bandage without active manual compression
The 2 groups showed no statistically significant differences regarding MACE with p value > 0.005 .
As regards local vascular complications, there was no statistically significant differences between the 2 groups .
● Time before ambulation was significantly reduced in the radial group (5.7 versus 12.5 hours, p < 0.001) .
● Length of Hospital stay (in hr s) : length of hospital stay was slightly higher in trans-femoral approach than trans-radial approach but without statistically significant differences ( p-value =0.286) between 2 groups as regards :Post procedure hospital stay was (46±3.5) in patient underwent PPCI via trans radial group and (48±3.0) in patient underwent PPCI via femoral approach
● Total procedural time was not significantly different between the two groups with (P-value >0 .005 ).
● Radiation exposure showed significant differences between the two groups with (P- value less than 0.005) with shorter radiation exposure in femoral approach.
*Sheath insertion time not including time of local anesthesia was significantly higher in radial approach than femoral approach P less than 0.005.