Background/Objectives: Transradial access (TRA) is a standard approach in the management of ST-segment elevation myocardial infarction (STEMI); however, evidence on using a single catheter for both diagnostic angiography and percutaneous coronary intervention (PCI) is limited. This study evaluates the feasibility and clinical outcomes of using a single Judkins Left (JL) 3.5 guiding catheter via TRA in STEMI patients. Methods: A total of 1139 patients undergoing radial access PCI with a single JL 3.5 catheter were included. Procedural success was defined as completing both diagnostic coronary angiography and PCI without catheter exchange. Procedural characteristics and access-site complications were evaluated. Results: The success rate of completing diagnostic angiography and PCI using a single JL 3.5 guiding catheter without catheter exchange was 91.1%. Compared to procedures requiring multiple catheters, the single-catheter group had significantly lower total contrast volume (200 vs. 250 mL), procedure time (20 vs. 30 min), fluoroscopy time (10.3 vs. 17.6 min), radiation dose (358 vs. 545 mGy), and needle-to-balloon time (6 vs. 9 min), all with p < 0.001. Access-site complications were also lower (8.2% vs. 15.8%; p = 0.010), primarily due to reduced radial artery spasm (4.0% vs. 12.9%; p = 0.001). Conclusions: A single JL 3.5 catheter strategy via transradial access is a safe, efficient, and effective method for STEMI intervention, offering significant procedural and clinical advantages.

Background/Objectives: The CALLY index draws on three admission tests—C-reactive protein, albumin, and lymphocyte count. We investigated whether it was associated with angiographic no-reflow after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We reviewed 1245 patients treated at one center between January 2024 and January 2026. Logistic regression accounted for clinical risk factors, baseline Thrombolysis in Myocardial Infarction (TIMI) flow, culprit artery, thrombus grade 5, Killip class at the start of PCI, and door-to-balloon time. We also tested alternative endpoint definitions, assessed influential observations, and compared correlated receiver operating characteristic (ROC) curves. Results: No-reflow occurred in 206 patients (16.5%). CALLY was lower in this group than in the reflow group (median 1.11 [0.39–1.92] vs. 1.33 [0.73–2.11]). Each one-unit increase in ln(CALLY) was associated with lower odds of no-reflow after adjustment (odds ratio [OR] 0.800, 95% confidence interval [CI] 0.693–0.923; p = 0.0023). The association remained when the endpoint was limited to impaired final angiographic reperfusion (OR 0.832, 0.717–0.965; p = 0.015). Discrimination by CALLY alone was poor (area under the curve [AUC] 0.578, 0.534–0.623); it was not significantly better than its components or the other indices studied. At a displayed threshold of ≤0.905, positive and negative predictive values were 22.8% and 86.8%. The association weakened after removal of the upper and lower 1% of values (p = 0.063). Conclusions: Admission CALLY was associated with recorded angiographic no-reflow, even after broader adjustment. Its weak discrimination and small incremental contribution, however, do not support use for individual risk classification without further study.