BACKGROUND: Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However, there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access. AIMS: To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI. To determine the impact of a single dedicated radial guide catheter on CCLD2BT and D2BT in transradial PPCI compared to conventional transfemoral PPCI. METHODS: The procedural and clinical outcomes of consecutive patients who had transradial primary PCI between 2005 and 2009 were included in this study and compared with a matched cohort who underwent transfemoral primary PCI. RESULTS: Overall D2BT and inpatient MACE were similar between the radial (n=53) and femoral (n=53) groups (85 and 82min, P=0.889; 0 and 1.8 P=0.317 respectively). An increase in the CCL2BT and procedural times was noted in the radial compared to the femoral group (34min versus 29min P=0.028; 15.8min versus 11.6min P=0.001). When a single radial guide catheter was used for the entire procedure, there was no difference in CCL2BT, D2BT and procedural times between the radial and femoral groups (31min versus 29min P=0.599; 74min versus 82min P=0.418; 50min versus 47min P=0.086). CONCLUSION: The radial approach is safe and results in guideline recommended D2BT in STEMI. The use of a dedicated radial guide catheter reduces treatment time, demonstrating equivalent times to a femoral approach.