Transulnar Versus Transradial Access for Coronary Angiography and Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Ramy SedhomSean Janzer

Abstract

To compare the outcomes of transulnar access (TUA) versus transradial access (TRA) for coronary angiography (CA) and percutaneous coronary intervention (PCI). TUA has emerged as an alternative access site in patients who fail TRA or not candidates for it. Data comparing both approaches have been limited. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared outcomes of TUA versus TRA for CA and/or PCI. Data from seven RCTs, with 5721 patients (TUA = 2874 and TRA = 2847), were analyzed. TUA, compared with TRA, was associated with a similar risk of major adverse cardiovascular and cerebrovascular events (MACCE) (3.05% vs. 3.32%, OR 0.9, 95% CI [0.65, 1.25]; P = 0.53), access cross-over rate (9.4% vs. 4.1%, OR 1.92, 95% CI [0.91, 4.06]; P = 0.09), access-site complications (12.7% vs. 13%, OR 0.97, 95% CI [0.79, 1.19]; P = 0.75), vasospasm (8.1% vs. 9%, OR 0.83, 95% CI [0.54, 1.27]; P = 0.38), procedural time (MD 1.34 min, 95% CI [-1.31, 3.99]; P = 0.32) and fluoroscopy time (MD 0.29 min, 95% CI [-0.33, 0.91]; P = 0.36). Additional analysis of patients who underwent PCI showed no difference in the incidence of MACCE, access-site complications and large hematoma. The risk of local bl...Continue Reading

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Citations

Jan 25, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Eline H PloumenJanine A van Til
Feb 27, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Khalil Ibrahim, Adhir R Shroff
Sep 14, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Muhammad U ManzoorSultan M Al-Qahtani

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