Clinical InvestigationInterventional CardiologyTransradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction: Systematic overview and meta-analysis
Section snippets
Search strategy
We performed a systematic review of the available literature according to the MOOSE guidelines for the conduct of meta-analyses of observational studies.17 Relevant studies published between January 1993 and August 2009 were identified from MEDLINE, SCOPUS, the Web of Science with Conference Proceedings, and the Cochrane Central Register of Controlled trials using a search strategy that combined text word and MeSH heading. Search keywords included various combinations of the following terms:
Search results and study selection
Our search detected 213 citations. These included editorials, reviews, letters, or articles regarding other aspects of the radial approach. There were 62 observational studies investigating the feasibility and safety of the radial approach in a series of patients. Moreover, we found 13 studies comparing the radial and femoral approaches in a cohort of patients that included both elective and acute cases without reporting separate outcomes regarding the different settings. Twelve studies were
Discussion
The present meta-analysis found that transradial coronary intervention is highly effective and safe in the setting of acute MI. We demonstrated a significant benefit of using radial access for PCI in MI with respect to major bleeding as well as in MACE. These findings were consistent in the setting of primary and rescue PCI.
Bleeding events have been demonstrated to be associated with an increased risk of MACE including death and recurrent ischemic events in multiple studies.13, 14, 31 Although
References (34)
- et al.
Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; systematic overview and meta-analysis of randomized trials
J Am Coll Cardiol
(2004) - et al.
Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials
Am Heart J
(2009) - et al.
Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison
Am Heart J
(1999) - et al.
Radial versus femoral access for emergent percutaneous coronary intervention with adjunct glycoprotein IIb/IIIa inhibition in acute myocardial infarction—the RADIAL-AMI pilot randomized trial
Am Heart J
(2005) - et al.
Comparison of transradial and transfemoral approaches for coronary angiography and angioplasty in octogenarians (the OCTOPLUS study)
Am J Cardiol
(2004) - et al.
Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites
J Am Coll Cardiol
(1998) - et al.
Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes: an analysis from the ACUITY Trial
J Am Coll Cardiol
(2007) - et al.
Systematic review and meta-analysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention
Am Heart J
(2008) - et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?
Control Clin Trials
(1996) - et al.
Transradial approach for percutaneous coronary stenting in the treatment of acute myocardial infarction
Rev Esp Cardiol
(2004)
Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of Early Invasive and Conservative Treatment in Patients With Non-ST-ElevatiOn Acute Coronary Syndromes [PRESTO-ACS] Vascular Substudy)
Am J Cardiol
Percutaneous transradial artery approach for coronary stent implantation
Cathet Cardiovasc Diagn
Right radial access for PTCA: a prospective study demonstrates reduced complications and hospital charges
J Invasive Cardiol
Rescue percutaneous coronary intervention using transradial arterial access with glycoprotein IIb/IIIa inhibitor eptifibatide therapy initiated post-fibrinolysis
J Invasive Cardiol
Effects and safety of intracoronary thrombectomy using transradial application of the PercuSurge distal balloon protection system in patients with early or recent myocardial infarction
Cardiology
Safety, feasibility and efficacy of transradial primary angioplasty in patients with acute myocardial infarction
Ital Heart J
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Society of Interventional Radiology Quality Improvement Standards on Radial Artery Access
2021, Journal of Vascular and Interventional RadiologyCitation Excerpt :Since then, the prevalence of using TRA for coronary procedures has increased significantly, and, as of 2015, the European Society of Cardiology guidelines recommend radial access over transfemoral access (intraarterial recommendation) for coronary angiography and intervention (2). The interest in TRA has been driven by multiple prospective randomized trials, meta-analyses, and retrospective cardiology studies demonstrating significant benefits of TRA compared to transfemoral access (3), including but not limited to: patient preference (4), decreased access site complications in general (5–8), and, for elderly patients (9,10), decreased overall complications and decreased mortality (11–14). Interventionalists in other specialties have been slower to adopt TRA, but recent publications by vascular surgeons (15–17), neurointerventionalists (18–22), and interventional radiologists (23–47) indicate that TRA is being used across a variety of procedures to treat many medical conditions outside of the heart.
Shared Decision-Making in Femoral Versus Radial Cardiac Catheterization
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