Mohamad Soud1, Ziad SayedAhmad2, Marvin Kajy3, Fares Alahdab4, Fahed Darmoch5, Yasser Al-Khadra6, Homam Moussa Pacha7, Yasar Sattar8, Waqas Ullah9, Fred King1, Ali Bani Saad3, Ghaith Alhatemi3, Zaher Hakim3, Omar E Ali3, James J Glazier3, M Chadi Alraies3. 1. Department of Cardiology, Rutgers New Jersey Medical School , Newark, New Jersey, USA. 2. Department of Internal Medicine, Beaumont Hospital , Royal Oak, MI, USA. 3. Department of Cardiology, Wayne State University, Detroit Medical Center , Detroit, Michigan, USA. 4. Department of Cardiology, Mayo Clinic Evidence-based Practice Center, Mayo Clinic , Rochester, MN, USA. 5. Department of Cardiology, Beth Israel Harvard University , Boston, MA, USA. 6. Department of Cardiology, Cleveland Clinic Foundation , Cleveland, Ohio, USA. 7. Department of Cardiology, University of Texas Health Science Center , Houston, Texas, USA. 8. Department Internal Medicine, City Queens, Icahn School of Medicine at Mount Sinai Elmhurst Hospital New York , USA. 9. Internal Medicine, Abington Jefferson Health , Abington, PA, USA.
Abstract
BACKGROUND: The clinical efficacy and safety of transradial (TR) percutaneous coronary intervention (PCI) in comparison to transfemoral (TF) for chronic total occlusion (CTO) is not well studied in literature. Objectives: We sought to study the outcome and complications associated with TR compared with TF for CTO interventions. METHODS: After a systematic literature search was done in PubMed and EMBASE, we performed a meta-analysis of studies comparing TF and TR for CTO PCI. Results: Twelve studies with 19,309 patients were included. Compared to those who has TF access, individuals who were treated via TR approach had statistically significant lower access complication rates [odds ratio (OR): 0.33; 95% confidence interval (CI): 0.22 to 0.49; p < 0.0001]. The procedural success was in the favor of TR method (OR: 1.4; 95% CI: 1.31-1. 51; p < 0.0001). The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) and contrast-induced nephropathy were similar in both groups. CONCLUSION: When compared with TF access interventions in CTO PCI; the TR approach appears to be associated with far less access-site complications, higher procedural success, and comparable MACCE.
BACKGROUND: The clinical efficacy and safety of transradial (TR) percutaneous coronary intervention (PCI) in comparison to transfemoral (TF) for chronic total occlusion (CTO) is not well studied in literature. Objectives: We sought to study the outcome and complications associated with TR compared with TF for CTO interventions. METHODS: After a systematic literature search was done in PubMed and EMBASE, we performed a meta-analysis of studies comparing TF and TR for CTO PCI. Results: Twelve studies with 19,309 patients were included. Compared to those who has TF access, individuals who were treated via TR approach had statistically significant lower access complication rates [odds ratio (OR): 0.33; 95% confidence interval (CI): 0.22 to 0.49; p < 0.0001]. The procedural success was in the favor of TR method (OR: 1.4; 95% CI: 1.31-1. 51; p < 0.0001). The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) and contrast-induced nephropathy were similar in both groups. CONCLUSION: When compared with TF access interventions in CTO PCI; the TR approach appears to be associated with far less access-site complications, higher procedural success, and comparable MACCE.