TY - JOUR
T1 - Efficacy and safety of distal radial approach for cardiac catheterization
T2 - A systematic review and meta-analysis
AU - Izumida, Toshihide
AU - Watanabe, Jun
AU - Yoshida, Ryo
AU - Kotani, Kazuhiko
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - BACKGROUND The traditional radial approach (RA) is recommended as the standard method for coronary angiography (CAG), while a distal RA (DRA) has been recently used for CAG. AIM To assess the efficacy and safety of the DRA vs RA during CAG. METHODS The following databases were searched through December 2020: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials.gov. Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included. The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm (RAS) and radial artery occlusion (RAO). Study selection, data abstraction and quality assessment were independently performed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Three randomized control trials and 13 registered trials were identified. The two approaches showed similar successful cannulation rates [risk ratio (RR) 0.90, 95% confidence interval (CI): 0.72-1.13]. The DRA did not decrease RAS (RR 0.43, 95%CI: 0.08-2.49) and RAO (RR 0.48, 95%CI: 0.18-1.29). Patients with the DRA had a shorter hemostasis time in comparison to those with the RA (mean difference - 6.64, 95%CI: -10.37 to -2.90). The evidence of certainty was low. CONCLUSION For CAG, the DRA would be safer than the RA with comparable cannulation rates. Given the limited data, additional research, including studies with standard protocols, is necessary.
AB - BACKGROUND The traditional radial approach (RA) is recommended as the standard method for coronary angiography (CAG), while a distal RA (DRA) has been recently used for CAG. AIM To assess the efficacy and safety of the DRA vs RA during CAG. METHODS The following databases were searched through December 2020: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials.gov. Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included. The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm (RAS) and radial artery occlusion (RAO). Study selection, data abstraction and quality assessment were independently performed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Three randomized control trials and 13 registered trials were identified. The two approaches showed similar successful cannulation rates [risk ratio (RR) 0.90, 95% confidence interval (CI): 0.72-1.13]. The DRA did not decrease RAS (RR 0.43, 95%CI: 0.08-2.49) and RAO (RR 0.48, 95%CI: 0.18-1.29). Patients with the DRA had a shorter hemostasis time in comparison to those with the RA (mean difference - 6.64, 95%CI: -10.37 to -2.90). The evidence of certainty was low. CONCLUSION For CAG, the DRA would be safer than the RA with comparable cannulation rates. Given the limited data, additional research, including studies with standard protocols, is necessary.
KW - Cardiac catheterization
KW - Coronary angiography
KW - Meta-analysis
KW - Radial artery
KW - Snuff box
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85107544023&partnerID=8YFLogxK
U2 - 10.4330/WJC.V13.I5.144
DO - 10.4330/WJC.V13.I5.144
M3 - 総説
AN - SCOPUS:85107544023
SN - 1949-8462
VL - 13
SP - 144
EP - 154
JO - World Journal of Cardiology
JF - World Journal of Cardiology
IS - 5
ER -