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Background Previous trials indicated that radial access was superior to conventional femoral access for percutaneous coronary intervention in reducing bleeding and vascular complications in patients with acute coronary syndrome (ACS).However, the overall safety and efficacy of transradial coronary intervention (TRI) with drug eluting stent (DES) versus coronary artery bypass grafting (CABG) for patients with unprotected left main disease (UPLM) presenting with ACS is unknown.