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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

Meta-analyses of primary outcomes. A, Comparison of the leftradial approach (LRA) versus the right radial approach (RRA) for proceduralfailure. B, Comparison of the LRA versus the RRA for fluoroscopytime. In the study of Sciahbasi (13), wereported the meta-analysis results of percutaneous coronary intervention (PCI) anddiagnostic angiography (Angio). See Table1 for numbers of all references cited.
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f02: Meta-analyses of primary outcomes. A, Comparison of the leftradial approach (LRA) versus the right radial approach (RRA) for proceduralfailure. B, Comparison of the LRA versus the RRA for fluoroscopytime. In the study of Sciahbasi (13), wereported the meta-analysis results of percutaneous coronary intervention (PCI) anddiagnostic angiography (Angio). See Table1 for numbers of all references cited.

Mentions: Data on procedural failures that followed operations were available for 11 studies with5912 participants (Figure 2A). There was nosignificant difference between the LRA and the RRA in the rate of procedural failure(RR=0.98, 95%CI=0.77-1.25). The LRA had a significantly shorter fluoroscopy time thanthe RRA (SMD=-0.14, 95%CI=-0.19 to -0.09; P<0.00001; Figure 2B).


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)

Meta-analyses of primary outcomes. A, Comparison of the leftradial approach (LRA) versus the right radial approach (RRA) for proceduralfailure. B, Comparison of the LRA versus the RRA for fluoroscopytime. In the study of Sciahbasi (13), wereported the meta-analysis results of percutaneous coronary intervention (PCI) anddiagnostic angiography (Angio). See Table1 for numbers of all references cited.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f02: Meta-analyses of primary outcomes. A, Comparison of the leftradial approach (LRA) versus the right radial approach (RRA) for proceduralfailure. B, Comparison of the LRA versus the RRA for fluoroscopytime. In the study of Sciahbasi (13), wereported the meta-analysis results of percutaneous coronary intervention (PCI) anddiagnostic angiography (Angio). See Table1 for numbers of all references cited.
Mentions: Data on procedural failures that followed operations were available for 11 studies with5912 participants (Figure 2A). There was nosignificant difference between the LRA and the RRA in the rate of procedural failure(RR=0.98, 95%CI=0.77-1.25). The LRA had a significantly shorter fluoroscopy time thanthe RRA (SMD=-0.14, 95%CI=-0.19 to -0.09; P<0.00001; Figure 2B).

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