Efficacy and safety of distal transradial access for coronary angiography or percutaneous coronary intervention: a meta-analysis

Qinyan Yang ¹ Xianli Wei ¹ Jianyu Wu ¹ Chunlan Li ¹ Yuechen Qin ¹ Haijian Zeng ¹ Mengtian Qin ¹ Yue Zou ¹ Shiming Zhang ¹ Weiming Liang ¹ Jie Li ^2*

• ¹ Guangxi University of Science and Technology, Liuzhou, Guangxi Zhuang Region, China
• ² First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, China

This meta-analysis aims to evaluate the efficacy and safety of dTRA for coronary angiography (CAG) or percutaneous coronary intervention (PCI) compared with cTRA.Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from the establishment of the databases to April 13, 2024, for articles studying dTRA compared to cTRA in coronary diagnostic or interventional catheterization. Meta-analyses of RAO, procedure success, success rate of catheter puncture, success rate of a single attempt, hematoma, radial artery spasm, puncture point bleeding, puncture time, procedural time, dosage of contrast medium, and hemostasis time.Results: Totally 31 studies were included for meta-analysis. Compared with cTRA, dTRA significantly reduced the incidence of RAO (OR = 0.41, 95% CI: 0.34 to 0.50, P<0.05), hematoma (OR=0.67, 95%CI:0.56 to 0.80, P<0.05) and shorter hemostasis time (WMD=-0.43, 95%CI:-0.65 to -0.20, P<0.05), but had significantly lower procedure success (OR=0.41, 95%CI: 0.30 to 0.56,P<0.05), lower success rate of catheter puncture (OR=0.44, 95%CI: 0.27 to 0.71, P<0.05) and longer puncture time (WMD=0.60, 95%CI: 0.44 to 0.75, P<0.05). There was no significant difference in Success rate of a single attempt, radial artery spasm, puncture point bleeding, procedural time, dosage of contrast medium.Our results revealed that dTRA is a workable and secure method for cardiovascular interventional diagnostics and treatment, which can significantly reduce the incidence of RAO and hematoma, as well as the hemostasis time following surgery.