{"title":"Efficacy and safety of distal transradial access for coronary angiography and percutaneous coronary intervention: a meta-analysis.","authors":"Qinyan Yang, Xianli Wei, Jianyu Wu, Chunlan Li, Yuechen Qin, Haijian Zeng, Mengtian Qin, Yue Zou, Shiming Zhang, Weiming Liang, Jie Li","doi":"10.3389/fcvm.2025.1530995","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aims to evaluate the efficacy and safety of dTRA for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in comparison to cTRA.</p><p><strong>Materials and methods: </strong>Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from their inception to 13 April 2024 for studies comparing dTRA and cTRA in coronary diagnostic or interventional catheterization. The meta-analysis evaluated radial artery occlusion (RAO), procedure success, the success rate of catheter puncture, the success rate of a single attempt, hematoma occurrence, radial artery spasms, puncture site bleeding, puncture time, procedural time, the dosage of contrast medium, and hemostasis time.</p><p><strong>Results: </strong>A total of 31 studies were included in the meta-analysis. Compared with cTRA, dTRA significantly reduced the incidence of RAO [odds ratio (OR) = 0.41, 95% CI: 0.34-0.50, <i>P</i> < 0.05], hematoma (OR = 0.67, 95% CI:0.56-0.80, <i>P</i> < 0.05), and shorter hemostasis time [weighted mean difference (WMD) = -0.43, 95% CI:-0.65 to -0.20, <i>P</i> < 0.05] but had a significantly lower procedure success rate (OR = 0.41, 95% CI: 0.30-0.56, <i>P</i> < 0.05), a lower catheter puncture success rate (OR = 0.44, 95% CI: 0.27-0.71, <i>P</i> < 0.05), and a longer puncture time (WMD = 0.60, 95% CI: 0.44-0.75, <i>P</i> < 0.05). No significant differences were observed between dTRA and cTRA in terms of the success rate of a single attempt, radial artery spasms, puncture site bleeding, procedural time, and dosage of contrast medium.</p><p><strong>Conclusions: </strong>Our results revealed that dTRA is a workable and safe method for cardiovascular interventional diagnostics and treatment. It significantly reduces the incidence of RAO and hematoma, as well as shortens hemostasis time following surgery.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024596238, PROSPERO (CRD42024596238).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1530995"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959052/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cardiovascular Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcvm.2025.1530995","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: This meta-analysis aims to evaluate the efficacy and safety of dTRA for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in comparison to cTRA.
Materials and methods: Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from their inception to 13 April 2024 for studies comparing dTRA and cTRA in coronary diagnostic or interventional catheterization. The meta-analysis evaluated radial artery occlusion (RAO), procedure success, the success rate of catheter puncture, the success rate of a single attempt, hematoma occurrence, radial artery spasms, puncture site bleeding, puncture time, procedural time, the dosage of contrast medium, and hemostasis time.
Results: A total of 31 studies were included in the meta-analysis. Compared with cTRA, dTRA significantly reduced the incidence of RAO [odds ratio (OR) = 0.41, 95% CI: 0.34-0.50, P < 0.05], hematoma (OR = 0.67, 95% CI:0.56-0.80, P < 0.05), and shorter hemostasis time [weighted mean difference (WMD) = -0.43, 95% CI:-0.65 to -0.20, P < 0.05] but had a significantly lower procedure success rate (OR = 0.41, 95% CI: 0.30-0.56, P < 0.05), a lower catheter puncture success rate (OR = 0.44, 95% CI: 0.27-0.71, P < 0.05), and a longer puncture time (WMD = 0.60, 95% CI: 0.44-0.75, P < 0.05). No significant differences were observed between dTRA and cTRA in terms of the success rate of a single attempt, radial artery spasms, puncture site bleeding, procedural time, and dosage of contrast medium.
Conclusions: Our results revealed that dTRA is a workable and safe method for cardiovascular interventional diagnostics and treatment. It significantly reduces the incidence of RAO and hematoma, as well as shortens hemostasis time following surgery.
期刊介绍：
Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers?
At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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