Izumida T, Watanabe J, Yoshida R, Kotani K. Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis. World J Cardiol 2021; 13(5): 144-154 [PMID: 34131477 DOI: 10.4330/wjc.v13.i5.144]
Corresponding Author of This Article
Kazuhiko Kotani, MD, PhD, Doctor, Full Professor, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City 329-0498, Tochigi, Japan. kazukotani@jichi.ac.jp
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. May 26, 2021; 13(5): 144-154 Published online May 26, 2021. doi: 10.4330/wjc.v13.i5.144
Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis
Toshihide Izumida, Jun Watanabe, Ryo Yoshida, Kazuhiko Kotani
Toshihide Izumida, Division of Community Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi 935-8531, Toyama, Japan
Jun Watanabe, Kazuhiko Kotani, Center for Community Medicine, Jichi Medical University, Shimotsuke-City 329-0498, Tochigi, Japan
Ryo Yoshida, Department of Internal Medicine, Iwami Hospital, Iwami-Town 681-0003, Tottori, Japan
Author contributions: Izumida T contributed acquisition of data, analysis and interpretation of data, drafting the article, and final approval; Watanabe J contributed conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article, and final approval; Yoshida R contributed analysis and interpretation of data, and final approval; Kotani K contributed interpretation of data, critical revision, and final approval.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kazuhiko Kotani, MD, PhD, Doctor, Full Professor, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City 329-0498, Tochigi, Japan. kazukotani@jichi.ac.jp
Received: January 11, 2021 Peer-review started: January 11, 2021 First decision: February 28, 2021 Revised: March 9, 2021 Accepted: April 26, 2021 Article in press: April 26, 2021 Published online: May 26, 2021 Processing time: 133 Days and 6.4 Hours
ARTICLE HIGHLIGHTS
Research background
While the traditional radial approach (RA) is the gold standard method for cardiac catheterization, a distal RA (DRA) has been recently introduced.
Research motivation
The DRA may have some advantages compared to RA; however, it is not fully understood as to which technique for coronary angiography—DRA or RA—is more beneficial to the patients.
Research objectives
Via the systematic review and meta-analysis, we compared clinical data using the DRA and RA.
Research methods
The databases MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov were searched. All randomized-controlled trials for adult patients undergoing cardiac catheterization until December 2020 were included. The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm (RAS) and radial artery occlusion (RAO). The statistical analysis was performed on a random-effect model to pool the relative risk ratios (RRs) and 95% confidence intervals (CIs) for the binary variables, such as cannulation success, RAS, and RAO.
Research results
Three randomized-control trials including 519 participants and 13 registered trials were identified. The two approaches showed similar successful cannulation rates (RR 0.90, 95%CI: 0.72-1.13). The DRA did not decrease RAS (RR 0.43, 95%CI: 0.08-2.49) and RAO (RR 0.48, 95%CI: 0.18-1.29). The evidence of certainty was low.
Research conclusions
The present study indicated the DRA to be safer than the RA, with comparable procedure rates. Importantly, there are limitations, including the limited study numbers and no studies with standard protocols, that prevent definitive conclusions.
Research perspectives
Further research, including studies with standard protocols, is required to establish clinical practice using the DRA.
