Meta-Analysis of Randomized Trials Comparing Distal Transradial Versus Conventional Transradial Approach for Coronary Procedures

Elbadawi, Ayman; Elgendy, Islam Y.; Jia, Xiaoming; Hamed, Mohamed; Shnoda, Mina; Eid, Mennaallah; Rahman, Faisal; Khalid, Umair; Paniagua, David; Jneid, Hani

doi:10.1016/j.amjcard.2022.02.009

The American Journal of Cardiology

2022

DOI: 10.1016/j.amjcard.2022.02.009

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Meta-Analysis of Randomized Trials Comparing Distal Transradial Versus Conventional Transradial Approach for Coronary Procedures

Ayman Elbadawi

Islam Y. Elgendy

Xiaoming Jia

et al.

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“…Prior meta-analyses on this topic have aggregated data from these studies with mixed results due to the heterogenous quality of evidence. 7,8 The DISCO RADIAL (Distal vs. Conventional Radial Access) trial 9 is the largest RCT to date that compared access-site complications and the safety profile of these 2 techniques.…”

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confidence: 99%

Distal Trans-radial Access Compared to Conventional Trans-radial Access in Coronary Interventions: A Meta-analysis

Talha

Waqar

Ashley

et al. 2022

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Background: Distal trans-radial access (dTRA) is a novel technique of arterial cannulation in coronary interventions. The comparative efficacy of dTRA and conventional trans-radial access (TRA) in attenuating periprocedural complications is unknown. Methods: Embase and PubMed/MEDLINE were searched from their inception until June 25, 2022, for randomized clinical trials. Outcomes included were radial artery occlusion (RAO), radial artery spasm, hemostasis time, access time, unsuccessful cannulation, crossover rate, and early discharge after transradial stenting of coronary arteries (EASY) type I-III hematomas. Statistical analysis was conducted using the random effects model to derive risk ratios (RRs) and mean differences (MDs) with their corresponding 95% confidence intervals (CIs). Results: A total of 6 randomized clinical trials comprising 3240 patients were included. Subjects were predominantly male (73%) and had a mean age of 66 years. The dTRA group had a lower risk of RAO [RR 0.43 (95% CI, 0.26-0.69); P = 0.0005; I 2 = 0%] and had a shorter hemostasis time [MD −22.85 min (95% CI, −39.06 to −6.65); P = 0.006; I 2 = 99%]. The dTRA group had a higher crossover rate [RR 3.04 (95% CI, 1.88-4.91); P = 0.00001; I 2 = 56%] and a longer access time [MD 0.68 min (95% CI, 0.17-1.18); P = 0.009; I 2 = 99%]. The TRA group had a lower rate of unsuccessful cannulation [RR 0.81 (95% CI, 0.70-0.95); P = 0.01; I 2 = 92%]. There was no significant difference between the groups for radial artery spasm and EASY type I-III hematomas. Conclusion: dTRA is a safe alternative to conventional TRA for coronary interventions with a lower risk of RAO. Future trials are required to further compare both approaches.

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mentioning

confidence: 99%

Distal Trans-radial Access Compared to Conventional Trans-radial Access in Coronary Interventions: A Meta-analysis

Talha

Waqar

Ashley

et al. 2022

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

View full text Add to dashboard Cite

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Meta-Analysis of Randomized Trials Comparing Distal Transradial Versus Conventional Transradial Approach for Coronary Procedures

Cited by 1 publication

References 5 publications

Distal Trans-radial Access Compared to Conventional Trans-radial Access in Coronary Interventions: A Meta-analysis

Distal Trans-radial Access Compared to Conventional Trans-radial Access in Coronary Interventions: A Meta-analysis

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