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Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients.

Xia SL, Zhang XB, Zhou JS, Gao X - Braz. J. Med. Biol. Res. (2015)

Bottom Line: There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38).A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02).We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

View Article: PubMed Central - PubMed

Affiliation: Affiliated Nanjing Jiangbei People's Hospital, Department of Cardiology, Southeast University, Nanjing, Jiangsu, China.

ABSTRACT
The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009). There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001) was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

No MeSH data available.


Related in: MedlinePlus

Flowchart of study selection.
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Related In: Results  -  Collection

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f01: Flowchart of study selection.

Mentions: As shown in Figure 1, we initially identified 852records from key reference databases and additional relevant articles; 629 potentiallyrelevant studies were kept after duplicates were eliminated. Of those, a total of 588studies were excluded after a review of the abstracts revealed that they were either notrelevant or not RCTs. An additional 27 of the remaining 41 studies were eliminated aftera reading of the full text. A total of 14 RCTs involving 6870 participants satisfied theinclusion criteria and were included in this meta-analysis (13,1517,) .


Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients.

Xia SL, Zhang XB, Zhou JS, Gao X - Braz. J. Med. Biol. Res. (2015)

Flowchart of study selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541695&req=5

f01: Flowchart of study selection.
Mentions: As shown in Figure 1, we initially identified 852records from key reference databases and additional relevant articles; 629 potentiallyrelevant studies were kept after duplicates were eliminated. Of those, a total of 588studies were excluded after a review of the abstracts revealed that they were either notrelevant or not RCTs. An additional 27 of the remaining 41 studies were eliminated aftera reading of the full text. A total of 14 RCTs involving 6870 participants satisfied theinclusion criteria and were included in this meta-analysis (13,1517,) .

Bottom Line: There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38).A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02).We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

View Article: PubMed Central - PubMed

Affiliation: Affiliated Nanjing Jiangbei People's Hospital, Department of Cardiology, Southeast University, Nanjing, Jiangsu, China.

ABSTRACT
The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009). There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001) was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

No MeSH data available.


Related in: MedlinePlus