Systematic Reviews
Copyright ©The Author(s) 2021.
World J Cardiol. May 26, 2021; 13(5): 144-154
Published online May 26, 2021. doi: 10.4330/wjc.v13.i5.144
Table 1 Summary of the characteristics of the eligible studies
Ref.
Country
Subject No.
Mean age in yr
Male, %
Right arm/left arm, n
CAG/PCI (n)
5-Fr sheath/6-Fr sheath, n
Operators
Medications to prevent radial artery spasm
Approach to hemostasis
Timing of assessment of radial artery occlusion
Mokbel et al[26], 2018Romania20063.4NSNSNSNSNSNitrateNSAt discharge
Koutouzis et al[25], 2019Greece20563.375.5152/48200/00/200SpecialistsVerapamil Manual compressionAt discharge
Vefalı et al[16], 2020Turkey11460.469.333/172156/49205/0NSNSManual compressionNS
Table 2 Quality scores for the studies eligible for the evaluation of the successful cannulation rate
Ref.
Risk of bias 2 tool assessment
Bias arising from the randomization process
Bias due to deviations from intended interventions
Bias due to missing outcome data
Bias in measurement of the outcome
Bias in selection of the reported results
Overall risk of bias
Mokbel et al[26]Some concernsLowLowLowSome concernsSome concerns
Koutouzis et al[25]LowLowLowLowSome concernsSome concerns
Vefalı et al[16]Some concernsLowLowLowSome concernsSome concerns
Table 3 Summary of findings (the efficacy and safety of the radial approach vs the distal radial approach for diagnostic coronary angiography and percutaneous coronary intervention)
Patient or population: Adults; Setting: Diagnostic coronary angiography and percutaneous coronary intervention; Intervention: Radial approach (RA); Comparison: Distal radial approach (DRA)
Outcomes
Anticipated absolute effects1 (95%CI)
Relative effect (95%CI)
Patient number (studies)
Certainty of the evidence, GRADE
Comments
Risk with RA
Risk with DRA
Successful cannulation rates950 per 1000798 per 1000 (532-1000)RR 0.90 [0.72-1.13]519 (3 RCTs)Low2,3DRA resulted in little to no difference in successful cannulation rates
Radial artery spasm39 per 100016 per 1000 (4-56)RR 0.43 [0.08-2.49]405 (2 RCTs)Low3DRA may reduce incidence of radial artery spasm
Radial artery occlusion32 per 100014 per 1000 (5-41)RR 0.48 [0.18-1.29]314 (2 RCTs)Low3DRA may reduce the incidence of radial artery occlusion
Mean number of punctures per patientThe mean number of punctures per patient were 2.4 in DRA in comparison to 1.6 in RA200 (1 RCT)Low3DRA may reduce the mean number of punctures per patient
Mean time for hemostasis-MD 6.64 min lower (10.37 lower to 2.9 lower)-405 (2 RCTs)Very low2,3,4DRA reduced mean time for hemostasis