**2. Vascular access in acute myocardial infarction; radial or femoral**

There is ongoing debate about which of the two commonly used primary percutaneous coro‐ nary intervention (PCI) methods, the traditional femoral artery access, or the radial artery access should physicians use. Some physicians support use of the femoral artery method because of concerns on the adequacy of support with the radial route. The claim is that femo‐ ral approach can provide stronger support for more complex procedures that require bulkier hardware; kissing balloons, crush techniques, and rotablation. However, most PPCI proce‐ dures do not entail densely calcific lesions or complex bifurcations. Most of the trials show that using radial access is feasible in the PPCI procedure and compared with femoral access; can provide a bleeding and mortality advantage.

ST‐segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI) are likely to benefit from the bleeding reduction by using the radial approach as these patients have more risk for access site bleeding and bleeding‐related complica‐ tions as in primary percutaneous intervention we use aggressive antiplatelet and antithrombotic therapies [1]. Using the radial approach may allow higher doses of anticoagulants to be used for further ischemic reduction with minimal bleeding incidence in comparison with using the femo‐ ral approach [2]. In addition, the use of the radial approach in STEMI patients has been associated with a significant reduction in major adverse cardiac events (MACE) during follow‐up [3].
