Distal Versus Proximal Radial Arterial Access for Percutaneous Coronary Angiography and Intervention: Updated Meta-Analysis of Randomized Controlled Trials

Mufarrih, Syed Hamza; Haider, Sajjad; Qureshi, Nada Qaisar; Khan, Mohammad Saud; Kazimuddin, Mohammed; Akbar, Muhammad Shoaib; Saleem, Sameer; Mufarrih, Syeda Aleena; Tripathi, Avnish; Singh, Aniruddha; Waheed, Mohammad Abdul

doi:10.1016/j.amjcard.2024.02.032

The American Journal of Cardiology

2024

DOI: 10.1016/j.amjcard.2024.02.032

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Distal Versus Proximal Radial Arterial Access for Percutaneous Coronary Angiography and Intervention: Updated Meta-Analysis of Randomized Controlled Trials

Syed Hamza Mufarrih,

Sajjad Haider,

Nada Qaisar Qureshi

et al.

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2024

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Cited by 8 publications

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Distal versus proximal radial access in coronary angiography: a meta-analysis

Lueg,

Schulze,

Stöhr

et al. 2024

Clin Res Cardiol

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Background Distal radial access (DRA) represents a promising alternative to conventional proximal radial access (PRA) for coronary angiography. Substantial advantages regarding safety and efficacy have been suggested for DRA, but the ideal access route remains controversial. Aims The aim of this study was to compare safety, efficacy and feasibility of DRA to PRA. Methods National Library of Medicine PubMed, Web of Science, clinicaltrials.gov and Cochrane Library were systematically searched for randomized controlled trials and registry studies comparing DRA and PRA that were published between January 1, 2017 and April, 2024. Primary endpoint was the rate of radial artery occlusion (RAO). Secondary endpoints were access failure, access time, procedure time, arterial spasm, hematoma, and hemostasis time. Data extraction was performed by two independent investigators. Relative risks were aggregated using a random effects model. We applied meta-analytic regression to assess study characteristic variables as possible moderators of the study effects. Results 44 studies with a total of 21,081 patients were included. We found a significantly lower rate of RAO after DRA (DRA 1.28%, PRA 4.76%, p < .001) with a 2.92 times lower risk compared to the proximal approach (Log Risk Ratio = −1.07, p < .001). Conversely, the risk for access failure was 2.42 times higher for DRA compared to PRA (Log Risk Ratio = 0.88, p < .001). Conclusion In this largest meta-analysis to date, we were able to show that rates of RAO are reduced with DRA compared to conventional PRA. This suggests DRA is a safe alternative to PRA. Graphical abstract

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Distal versus proximal radial access in coronary angiography: a meta-analysis

Lueg,

Schulze,

Stöhr

et al. 2024

Clin Res Cardiol

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No Penalty for Going Distal Radial

Pancholy,

Patel

2024

The American Journal of Cardiology

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Outcomes of graft angiography with distal radial access: a retrospective cohort study

Iqbal,

Kumar,

Mehmood

et al. 2024

Future Cardiology

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Distal Versus Proximal Radial Arterial Access for Percutaneous Coronary Angiography and Intervention: Updated Meta-Analysis of Randomized Controlled Trials

Cited by 8 publications

References 38 publications

Distal versus proximal radial access in coronary angiography: a meta-analysis

Distal versus proximal radial access in coronary angiography: a meta-analysis

No Penalty for Going Distal Radial

Outcomes of graft angiography with distal radial access: a retrospective cohort study

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