Comparison of Sheathless and Sheathed Guiding Catheters in Transradial Percutaneous Coronary Interventions: A Systematic Review and Meta-Analysis

IF 1.6 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Zuhair Majeed, Muhammad Haider Tariq, Arslan Ahmed, Muhammad Usama, Ahmed Mazen Amin, Abira Khan, Muhammad Shahzaib Bajwa, Muhammad Faiq Umar, Mustafa Turkmani, Mohamed Abuelazm, Ubaid Khan
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引用次数: 0

Abstract

Introduction: The sheathless transradial (TR) technique is a novel approach that may offer potential benefits over the conventional TR approach. We aim to comprehensively investigate the safety and efficacy of sheathless versus conventional TR percutaneous coronary interventions (PCIs).

Methods: We conducted comprehensive searches across PubMed, CENTRAL, Web of Science (WOS), Scopus, and EMBASE until July 2023. Pooled data were reported using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, along with a 95% confidence interval (CI). PROSPERO ID: CRD42023443834.

Results: We included 11 studies with 15,392 patients. The radial artery spasm (RAS) (RR: 0.26, 95% CI: [0.09, 0.77], p = 0.02) and cross-over to the femoral site (RR: 0.28, 95% CI: [0.10, 0.81], p = 0.02) were significantly lower in the sheathless group. However, radial artery occlusion (RAO) (RR: 2.84, 95% CI: [1.78, 4.54], p < 0.0001) and success rate (RR: 1.011, 95% CI: [1.004, 1.019], p = 0.002) were significantly higher in the sheathless group. Also, we did not find a significant difference between both groups in all-cause mortality (RR: 0.41, 95% CI: [0.16, 1.04], p = 0.06).

Conclusion: The sheathless TR approach showed lower rates of RAS and femoral conversion. Sheathless has a higher success rate; however, it also increased RAO. Thus, more trials are needed to confirm this technique’s long-term outcomes and complications.

Abstract Image

经桡动脉经皮冠状动脉介入治疗中无鞘和有鞘导引导管的比较:系统回顾与元分析
简介:无鞘经桡动脉(TR)技术是一种新型方法,与传统的TR方法相比具有潜在优势。我们旨在全面研究无鞘经皮冠状动脉介入治疗(PCI)与传统经皮冠状动脉介入治疗(TR)的安全性和有效性。 方法:截至 2023 年 7 月,我们在 PubMed、CENTRAL、Web of Science (WOS)、Scopus 和 EMBASE 中进行了全面检索。对于二分结果,我们使用风险比 (RR) 报告汇总数据;对于连续结果,我们使用平均差 (MD) 报告汇总数据,并给出 95% 的置信区间 (CI)。PROSPERO ID:CRD42023443834。 结果:我们纳入了 11 项研究,共 15,392 名患者。无鞘组的桡动脉痉挛(RAS)(RR:0.26,95% CI:[0.09,0.77],P = 0.02)和股动脉部位交叉(RR:0.28,95% CI:[0.10,0.81],P = 0.02)显著低于无鞘组。然而,无鞘组的桡动脉闭塞(RAO)(RR:2.84,95% CI:[1.78,4.54],p = 0.0001)和成功率(RR:1.011,95% CI:[1.004,1.019],p = 0.002)明显更高。此外,我们没有发现两组在全因死亡率上有明显差异(RR:0.41,95% CI:[0.16,1.04],P = 0.06)。 结论无鞘 TR 方法的 RAS 和股骨转换率较低。无鞘的成功率更高,但也增加了RAO。因此,需要更多的试验来证实这种技术的长期效果和并发症。
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来源期刊
Journal of interventional cardiology
Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.80
自引率
0.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis
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