Distal snuffbox versus conventional radial artery access: An updated systematic review and meta-analysis

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Gianluca Rigatelli1, Marco Zuin2,3, Ramesh Daggubati4

  • 1Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy.

The Journal of Vascular Access
|April 1, 2021
PubMed

Insights

Distal transradial access significantly reduces the risk of radial artery occlusion compared to conventional transradial access. This meta-analysis found no significant differences in hematoma or spasm rates between the two approaches.

Area of Science:

  • Cardiovascular Interventions
  • Vascular Access Techniques
  • Interventional Cardiology

Background:

  • Transradial access is a common approach for coronary angiography and percutaneous coronary interventions.
  • Vascular complications remain a concern, with ongoing research into optimizing access sites.
  • A clear benefit of distal transradial access over conventional methods regarding complications is yet to be definitively established.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis comparing vascular complications between distal and conventional transradial access.
  • To provide an updated comparison of outcomes for coronary angiography and/or percutaneous coronary intervention.
  • To evaluate the safety and efficacy of distal versus conventional transradial access.

Main Methods:

  • Systematic review and meta-analysis of case-control studies.
  • Searched MEDLINE, Scopus, and Web of Science for relevant literature up to December 22, 2020.
  • Primary outcome: radial artery occlusion; Secondary outcomes: hematoma and spasm.

Main Results:

  • Analyzed data from 7073 patients across eight studies.
  • Significantly lower rate of radial artery occlusion with distal access (2.1%) compared to conventional access (4.6%).
  • No significant differences observed in hematoma or radial artery spasm rates between the groups.

Conclusions:

  • Distal transradial access is associated with a reduced risk of radial artery occlusion.
  • The safety profile regarding hematoma and spasm is comparable between distal and conventional transradial access.
  • Distal transradial access may offer advantages in reducing vascular complications during cardiac procedures.
Abstract

Keywords:
PCISnuffboxcoronary angiographyradial arteryvascular access

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