Photo Credit: Kintarapong

The following is a summary of “Distal versus proximal radial access in coronary angiography: a meta-analysis,” published in the September issue of Cardiology by Lueg et al.

Distal radial access (DRA) offers a potential alternative to proximal radial access (PRA) for coronary angiography. DRA may provide safety and efficacy benefits, but the best access route is still debated.

Researchers conducted a retrospective study to compare DRA’s safety, efficacy, and feasibility with PRA.

They searched PubMed, Web of Science, clinicaltrials.gov, and Cochrane Library for trials comparing distal and proximal radial access published from January 1, 2017, to April 2024. The primary endpoint was radial artery occlusion (RAO), and secondary endpoints included access failure and procedure times. Data was analyzed using a random effects model and meta-analytic regression.

The results showed that about 44 studies with 21,081 patients were analyzed. DRA had a significantly lower rate of RAO at 1.28% compared to PRA at 4.76% ( P< .001), showing a 2.92 times lower risk (Log Risk Ratio = −1.07,  P< .001). However, DRA had a 2.42 times higher risk of access failure than PRA (Log Risk Ratio = 0.88,  P< .001).

Investigators concluded that DRA reduces radial artery occlusion rates compared to proximal radial access (PRA), making DRA a safe alternative to PRA.

Source: link.springer.com/article/10.1007/s00392-024-02505-3