Safety and efficacy of dual-axis rotational vs standard coronary angiography: meta-analysis

The objective is to compare the safety and efficacy of dual-axis rotational coronary angiography (DARCA) with standard coronary angiography (SA). We performed a systematic review and meta-analysis comparing the efficacy of coronary lesions visualization and safety endpoints for patients with suspected coronary artery disease undergoing DARCA and SA. We searched PubMed, Google Scholar, and Cochrane databases for head-to-head trials. Mean differences (MD) with 95% confidence intervals (CI) were pooled with a random-effects model with a Paule-Mendel estimator using RStudio software. Three studies corresponding to 128 patients met the inclusion criteria. 128 (100%) patients underwent both DARCA and SA. Compared with SA, DARCA had no significant diagnostic accuracy difference for coronary lesion visualization (MD = -0.19 lesions per patient; 95% CI = [-0.52; 0.15]; p = 0.28) but was associated with a substantially lower contrast dose used (MD = -16.77 cm³; 95% CI = [-26.00; -7.55]; p < 0.01) and radiation exposure (MD = -11.89 Gycm²; 95% CI = [-17.09; -6.65]; p < 0.01). In the meta-analysis, DARCA had no significant difference in coronary lesion visualization and lower contrast and radiation used compared with SA.