Efficacy and safety of distal transradial access for coronary angiography and percutaneous coronary intervention: a meta-analysis.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-03-18 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1530995

Qinyan Yang, Xianli Wei, Jianyu Wu, Chunlan Li, Yuechen Qin, Haijian Zeng, Mengtian Qin, Yue Zou, Shiming Zhang, Weiming Liang, Jie Li

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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.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024596238, PROSPERO (CRD42024596238).

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简介：本荟萃分析旨在评估 dTRA 与 cTRA 相比在冠状动脉造影术（CAG）和经皮冠状动脉介入治疗（PCI）中的有效性和安全性：在四个数据库（PubMed、Embase、Web of Science 和 Cochrane Library）中搜索了从开始到 2024 年 4 月 13 日在冠状动脉诊断或介入导管术中比较 dTRA 和 cTRA 的研究。荟萃分析评估了桡动脉闭塞（RAO）、手术成功率、导管穿刺成功率、单次穿刺成功率、血肿发生率、桡动脉痉挛、穿刺部位出血、穿刺时间、手术时间、造影剂用量和止血时间：荟萃分析共纳入了 31 项研究。与 cTRA 相比，dTRA 能显著降低 RAO 的发生率[几率比（OR）= 0.41，95% CI：0.34-0.50，P P P P P P 结论：我们的研究结果表明，dTRA 能显著降低 RAO 的发生率：我们的研究结果表明，dTRA 是一种可行且安全的心血管介入诊断和治疗方法。系统综述注册：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024596238，PROSPERO (CRD42024596238)。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

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.