Title: Meta-Analysis of Randomized Trials Comparing Distal Transradial Versus Conventional Transradial Approach for Coronary Procedures
Abstract: Transradial approach (TRA) for vascular access is considered the default approach for diagnostic and interventional coronary procedures. 1 Tsigkas G Papageorgiou A Moulias A Kalogeropoulos AP Papageorgopoulou G Apostolos A Papanikolaou A Vasilagkos Davlouros P Distal or traditional transradial access site for coronary procedures: a single-center, randomized study. JACC Cardiovasc Interv. 2022; 15: 22-32 Crossref PubMed Scopus (20) Google Scholar ,2 Eid-Lidt G Rivera Rodríguez A Jimenez Castellanos J Farjat Pasos JI Estrada López KE Gaspar J Distal radial artery approach to prevent radial artery occlusion trial. JACC CardioVasc Interv. 2021; 14: 378-385 Crossref PubMed Scopus (61) Google Scholar However, a clinical complication unique to TRA is proximal radial artery occlusion (PRAO), with incidence of up to 7.7% at 24 hours and 5.5% at >1 week follow-up. 1 Tsigkas G Papageorgiou A Moulias A Kalogeropoulos AP Papageorgopoulou G Apostolos A Papanikolaou A Vasilagkos Davlouros P Distal or traditional transradial access site for coronary procedures: a single-center, randomized study. JACC Cardiovasc Interv. 2022; 15: 22-32 Crossref PubMed Scopus (20) Google Scholar ,2 Eid-Lidt G Rivera Rodríguez A Jimenez Castellanos J Farjat Pasos JI Estrada López KE Gaspar J Distal radial artery approach to prevent radial artery occlusion trial. JACC CardioVasc Interv. 2021; 14: 378-385 Crossref PubMed Scopus (61) Google Scholar Although the clinical implications of RAO are generally not significant, it affects the use of the radial artery in future procedures as a conduit for coronary artery bypass grafting surgery, future radial arterial access, and rarely, hand ischemia in cases of concomitant ulnar artery insufficiency. The distal TRA (dTRA) technique involves access of the radial artery at the level of the anatomic snuff box and can mitigate potential sequelae associated with PRAO. 3 Koutouzis M Kontopodis E Tassopoulos A Tsiafoutis I Katsanou K Rigatou A Didagelos M Andreou K Lazaris E Oikonomidis N Maniotis C Ziakas A. Distal versus traditional radial approach for coronary angiography. Cardiovasc Revasc Med. 2019; 20: 678-680 Crossref PubMed Scopus (83) Google Scholar However, randomized controlled trials (RCTs) investigating the merits of dTRA have been small-to-moderate sized and not powered to demonstrate the superiority of this approach. In that context, we conducted a meta-analysis of RCTs to evaluate the efficacy and safety of dTRA.
Publication Year: 2022
Publication Date: 2022-04-15
Language: en
Type: review
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 2
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