Translate 
Abstract
Objective: Cardiac catheterization using the distal radial artery (DRA) access, at the level of the anatomical snuff box post-radial artery bifurcation, may be linked to a lower rate of arterial occlusion and better hemostasis. In this meta-analysis, we compare DRA versus proximal radial artery (PRA) access in cardiac catheterization or angiography. Methods: A detailed literature search was performed on PubMed, Cochrane, Embase, and Clinicaltrials.gov from inception till June 2024. Risk ratios (RRs) and mean differences (MDs) were pooled for categorical and continuous outcomes, respectively. Random effects meta-analysis was undertaken on RevMan. Results: Our meta-analyses include 21 randomized controlled trials with 9,539 patients (DRA 4,761, PRA 4,778). DRA significantly reduced 24-h radial artery occlusion rates (RR 0.30, 95% CI: 0.23 to 0.40, p ≤ 0.00001) and time to hemostasis (minutes) (MD −44.46, 95% CI: −50.64 to −38.92, p < 0.00001), whereas PRA was significantly superior in terms of the puncture success rate (RR 0.96, 95% CI: 0.93 to 0.99, p < 0.01), the crossover rate (RR 2.89, 95% CI: 2.02 to 4.15, p < 0.00001), and puncture attempts (MD 0.69, 95% CI: 0.37 to 1.00, p = 0.00001). Conclusion: DRA was associated with a lower risk of occlusion and lower time to hemostasis, but required a greater number of puncture attempts and had lower success rate. Further research is required to elucidate the most optimal approach.
Published Version
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
