Benefit of radial approach in reducing the incidence of acute kidney injury after percutaneous coronary intervention: A meta-analysis of 22,108 patients

Andò, Giuseppe; Costa, Francesco; Boretti, Ilaria; Trio, Olimpia; Valgimigli, Marco

doi:10.1016/j.ijcard.2014.11.053

Cited by 25 publications

(16 citation statements)

References 11 publications

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“…15,22 Chiming in with our results, some studies have shown that the TRA may be associated with low rates of CIN by comparison with the TFA. [13][14][15][16] In 2010, British Columbia Cardiac and Renal Registries-the first investigation of its kind to explore the association between the vascular access site and the later onset of a new chronic kidney disease status in patients undergoing cardiac catheterization-showed that the TFA had an OR of 4.36 (95% CI: 2.48 to 7.66) for a new dialysis, a new stage IV or V chronic kidney disease, or a new chronic kidney disease, within 6 months after the cardiac procedure. 16 Kooiman et al in 2014 matched their study population in terms of propensity and found that the TRA approach was associated with lower adjusted odds of CIN (OR: 0.74 and 95% CI: 0.58 to 0.96) and bleeding (OR: 0.47 and 95% CI: 0.36 to 0.63).…”

Section: Discussionmentioning

confidence: 99%

“…14 In a large meta-analysis in 2015, Andò et al found that the TRA approach lowered the incidence of CIN after PCI and this benefit was likely to be mediated by a reduction in bleeding complications. 13 Recently in 2017, the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial showed that CIN was 3 times less prevalent and trended lower with the TRA approach (OR: 0.85, 95% CI: 0.70 to 1.03, and P = 0.090) than with the TFA approach in patients with the acute coronary syndrome who underwent invasive management. Additionally, postintervention dialysis was needed in 6 (0.15%) patients treated via the TRA and 14 (0.34%) patients treated via the TFA (P = 0.0814).…”

Section: Discussionmentioning

confidence: 99%

“…12 Recently, some studies have evaluated 2 routine accesses in angiography and angioplasty and suggested that the transradial access (TRA) may be associated with lower rates of CIN than the transfemoral access (TFA). [13][14][15][16] In contrast, some other reports have not been able to show the superiority of the TRA for the reduction of postprocedural CIN-even in high-volume radial centers. 17,18 Moreover, there is evidence indicating that different populations may have different risk factors for the development of nephropathy.…”

Section: Introductionmentioning

confidence: 86%

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Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

Firouzi

Alemzadeh‐Ansari

Mohammadhadi

et al. 2020

J Cardiovasc Thorac Res

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Introduction: The risk of contrast-induced nephropathy (CIN) as a common and important complication of coronary procedures may be influenced by the vascular access site. We compared the risks of CIN in diagnostic or interventional coronary management between patients treated via the transradial access (TRA) and those treated via the transfemoral access (TFA). Methods: Patients undergoing invasive coronary catheterization or percutaneous coronary intervention (PCI) were enrolled. We excluded patients with congenital or structural heart disease and those with end-stage renal disease on dialysis. Based on the vascular access site used for invasive coronary catheterization, the patients were divided into 2 study groups: the TFA and the TRA. CIN was defined as an absolute (≥0.5 mg/dL) or relative (>25%) increase in the baseline serum creatinine level within 48 hours following cardiac catheterization or PCI. Results: Overall, 410 patients (mean age = 61.3 ± 10.8 years) underwent diagnostic or interventional coronary management: 258 were treated via the TFA approach and 152 via the TRA approach. The patients treated via the TFA had a significantly higher incidence of postprocedural CIN (15.1% vs 6.6%; P = 0.01). The multivariate analysis showed that the TFA was the independent predictor of CIN (OR: 2.37, 95% CI: 1.11 to 5.10, and P = 0.027). Moreover, the BARC (Bleeding Academic Research Consortium) and Mehran scores were the other independent predictors of CIN in our study. Conclusion: The risk of CIN was lower with the TRA, and the TFA was the independent predictor of CIN after the diagnostic or interventional coronary management. Article info TUOMS P R E S SFirouzi et al J Cardiovasc Thorac Res, 2020, 12(1), 51-55 52

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

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Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

Firouzi

Alemzadeh‐Ansari

Mohammadhadi

et al. 2020

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

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“…The main advantages of the transradial approach over the transfemoral approach include patient convenience, reduced time to hemostasis, a lower risk of acute kidney injury, and improved outcomes such as a lower risk of bleeding. [1, 2] However, radial access is still associated with significant complications such as access site bleeding and vessel occlusion. [3]…”

Section: Introductionmentioning

confidence: 99%

Hemostasis pad combined with compression device after transradial coronary procedures: A randomized controlled trial

et al. 2017

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BackgroundArterial access and hemostasis are important processes during percutaneous coronary procedures. In this study, we tested if the use of chitosan-based pads on top of compression devices could improve hemostasis efficacy compared with compression devices alone after transradial coronary angiography or interventions.MethodsThis study was a single-center open-label randomized controlled trial. Patients who underwent coronary angiography or intervention with the transradial approach were randomly assigned to the study (compression device and a chitosan-based pad) or control (compression devices alone) group in a 2:1 fashion. The primary endpoint was time to hemostasis, categorized into ≤5, 6–10, 11–20, and >20 minutes.ResultsBetween April and July 2016, 95 patients were enrolled (59 were assigned to the study arm and 36 to the control arm). Time to hemostasis, the primary endpoint, was significantly lower in the study group than in the control group (p<0.001). Both groups showed low rates of vascular complications.ConclusionsThis study suggests that the use of a hemostasis pad in combination with rotatory compression devices is a safe and effective hemostasis strategy after radial artery access.Trial registrationClinicalTrials.gov NCT02954029

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“…Similarly, another propensity-matched study showed that TRA, compared to TFA, was associated with a lower risk of AKI[25]. Finally, a recent meta-analysis of observational studies (adjusted by propensity score matching) showed that TRA, compared to TFA, was associated with lower risk of AKI[26]. The primary mechanism by which TRA was associated with a lower risk of kidney injury is thought to be through a reduced likelihood of renal atheroembolization because it offers the additional advantage of avoiding passage through potential atheromatous aortae and renal vessels[9,23].…”

Section: Discussionmentioning

confidence: 99%

Contrast use in relation to the arterial access site for percutaneous coronary intervention: A comprehensive meta-analysis of randomized trials

Shah

Mattox

Khan

et al. 2017

WJC

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AIMTo compare the amount of contrast used during percutaneous coronary intervention (PCI) via trans-radial access (TRA) vs trans-femoral access (TFA).METHODSScientific databases and websites were searched for:randomizedcontrolledtrials (RCTs). Data were extracted by two independent reviewers and was summarized as the weighted mean difference (WMD) of contrast used with a 95%CI using a random-effects model.RESULTSThe meta-analysis included 13 RCTs with a total of 3165 patients. There was no difference between the two strategies in the amount of contrast used (WMD = - 0.65 mL, 95%CI: -10.94-9.46 mL; P = 0.901).CONCLUSIONThis meta-analysis shows that in patients undergoing PCI, the amount of contrast volume used was not different between TRA and TFA.

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Benefit of radial approach in reducing the incidence of acute kidney injury after percutaneous coronary intervention: A meta-analysis of 22,108 patients

Cited by 25 publications

References 11 publications

Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

Hemostasis pad combined with compression device after transradial coronary procedures: A randomized controlled trial

Contrast use in relation to the arterial access site for percutaneous coronary intervention: A comprehensive meta-analysis of randomized trials

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