远距离与传统辐射接入的交叉模式和时间趋势:随机试验的元分析
Mattia Basile1, Adel Aminian2, Alfonso Jurado-Román3
1Department of Cardiovascular Sciences-CUORE, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Cardiology Department, La Paz University Hospital, Madrid, Spain; Fundación de Investigación IDIPAZ, Madrid, Spain.
International journal of cardiology
|December 18, 2025
概括
距离辐射接入 (DRA) 的交叉率高于跨辐射接入 (TRA),但这种风险已经下降. 当交叉发生时,DRA减少了大腿部接入转换,保持了辐射第一安全性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管接入 血管接入
背景情况:
- 远端辐射接入 (DRA) 是通过皮肤进行冠状动脉手术的跨辐射接入 (TRA) 的替代方案.
- 人们对DRA的交叉率更高存在担忧,其演变尚未得到充分理解.
研究的目的:
- 在随机对照试验 (RCT) 中评估DRA与TRA的交叉模式和时间趋势.
主要方法:
- 对RCT进行系统审查和元分析,比较DRA和TRA.
- 主要结局:总交叉到另一个访问站点,按研究时代分层 (DISCO RADIAL试验前后).
- 二次结果:交叉到大腿部接入,并切换到另一个辐射接入.
主要成果:
- 分析了20个RCT (8868名患者);与DRA的整体交叉比较高 (OR2.78).
- 在DISCO RADIAL试验 (OR 2.14与4.23) 后,与DRA交叉率下降.
- 当交叉发生时,DRA显著降低了股骨接入转换 (OR 0.33),大多数切换到另一个辐射部位.
结论:
- 总体而言,DRA的交叉率高于TRA,但随着时间的推移,这已经下降了.
- 在需要交叉时,DRA显著减少了股骨转换.
- DRA保留了辐射第一策略的安全优势.
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