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Safety and Effectiveness of Coronary Angiography or Intervention through the Distal Radial Access: A Meta-Analysis

Jun Cao1, Huaxiu Cai2, Weibin Liu1

  • 1Department of Cardiology, Ganzhou Municipal Hospital, Ganzhou 341000, China.

Journal of Interventional Cardiology
|December 6, 2021
PubMed

Insights

Distal radial access (DRA) for coronary angiography is as effective as traditional transradial access (TRA) regarding success rates and hematoma. DRA significantly reduces radial artery occlusion and spasm, enhancing patient safety.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • Transradial access (TRA) is a common approach for coronary angiography and intervention.
  • Distal radial access (DRA) is an alternative technique with potential benefits.
  • Evaluating the comparative safety and efficacy of DRA versus TRA is crucial for clinical practice.

Purpose of the Study:

  • To conduct a meta-analysis comparing distal radial access (DRA) with transradial access (TRA) for coronary angiography (CAG) or intervention.
  • To assess the effectiveness and safety of DRA based on key clinical endpoints.

Main Methods:

  • Systematic literature search of randomized controlled trials (RCTs) comparing DRA and TRA.
  • Inclusion of studies published between January 1, 2017, and May 4, 2021, from PubMed, Embase, and Cochrane databases.
  • Meta-analysis using a random-effects model to evaluate access success, radial artery occlusion, radial artery spasm, and puncture site hematoma rates.

Main Results:

  • Six RCTs involving 2825 participants met the inclusion criteria.
  • DRA demonstrated a similar access success rate (p=0.1) and lower incidence of puncture site hematoma (p=0.646) compared to TRA.
  • DRA showed significantly lower rates of radial artery occlusion (p < 0.001) and radial artery spasm (p=0.029) than TRA.

Conclusions:

  • Distal radial access (DRA) offers comparable success rates and hematoma incidence to transradial access (TRA).
  • DRA significantly reduces the occurrence of radial artery occlusion and spasm.
  • These findings support DRA as a safe and effective alternative access route for coronary angiography and intervention.
Abstract

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