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Design and rationale of the radial versus femoral access for coronary intervention (RIVAL) trial: a randomized comparison of radial versus femoral access for coronary angiography or intervention in patients with acute coronary syndromes.

Publication ,  Journal Article
Jolly, SS; Niemelä, K; Xavier, D; Widimsky, P; Budaj, A; Valentin, V; Lewis, BS; Avezum, A; Steg, PG; Rao, SV; Cairns, J; Chrolavicius, S ...
Published in: Am Heart J
February 2011

BACKGROUND: Major bleeding in acute coronary syndromes (ACS) is associated with an increased risk of subsequent mortality and recurrent ischemic events. Observational data and small randomized trials suggest that radial instead of femoral access for coronary angiography/intervention results in fewer bleeding complications, with preserved and possibly improved efficacy. Radial access versus femoral access has yet to be formally evaluated in a randomized trial adequately powered for the comparison of clinically important outcomes. OBJECTIVES: The aim of this study is to evaluate the efficacy and safety of radial versus femoral access for coronary angiography/intervention in patients with ACS managed with an invasive strategy. DESIGN: This was a multicenter international randomized trial with blinded assessment of outcomes. 7021 patients with ACS (with or without ST elevation) have been randomized to either radial or femoral access for coronary angiography/intervention. The primary outcome is the composite of death, myocardial infarction, stroke, or non-coronary artery bypass graft-related major bleeding up to day 30. The key secondary outcomes are (1) death, myocardial infarction, or stroke up to day 30 and (2) non-coronary artery bypass graft-related major bleeding up to day 30. Percutaneous coronary intervention (PCI) success rates will also be compared between the two access sites. CONCLUSIONS: The RIVAL trial will help define the optimal access site for coronary angiography/intervention in patients with ACS.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

February 2011

Volume

161

Issue

2

Start / End Page

254-260.e1-4

Location

United States

Related Subject Headings

  • Radial Artery
  • Humans
  • Femoral Artery
  • Coronary Angiography
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
  • Acute Coronary Syndrome
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Jolly, S. S., Niemelä, K., Xavier, D., Widimsky, P., Budaj, A., Valentin, V., … Mehta, S. R. (2011). Design and rationale of the radial versus femoral access for coronary intervention (RIVAL) trial: a randomized comparison of radial versus femoral access for coronary angiography or intervention in patients with acute coronary syndromes. Am Heart J, 161(2), 254-260.e1-4. https://doi.org/10.1016/j.ahj.2010.11.021
Jolly, Sanjit S., Kari Niemelä, Denis Xavier, Petr Widimsky, Andrzej Budaj, Vicent Valentin, Basil S. Lewis, et al. “Design and rationale of the radial versus femoral access for coronary intervention (RIVAL) trial: a randomized comparison of radial versus femoral access for coronary angiography or intervention in patients with acute coronary syndromes.Am Heart J 161, no. 2 (February 2011): 254-260.e1-4. https://doi.org/10.1016/j.ahj.2010.11.021.
Jolly SS, Niemelä K, Xavier D, Widimsky P, Budaj A, Valentin V, Lewis BS, Avezum A, Steg PG, Rao SV, Cairns J, Chrolavicius S, Yusuf S, Mehta SR. Design and rationale of the radial versus femoral access for coronary intervention (RIVAL) trial: a randomized comparison of radial versus femoral access for coronary angiography or intervention in patients with acute coronary syndromes. Am Heart J. 2011 Feb;161(2):254-260.e1–4.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

February 2011

Volume

161

Issue

2

Start / End Page

254-260.e1-4

Location

United States

Related Subject Headings

  • Radial Artery
  • Humans
  • Femoral Artery
  • Coronary Angiography
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
  • Acute Coronary Syndrome
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1102 Cardiorespiratory Medicine and Haematology