Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis.
coronary angiography
hemostasis
percutaneous coronary intervention
radial access
radial artery occlusion
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
27 Nov 2022
27 Nov 2022
Historique:
received:
11
11
2022
accepted:
23
11
2022
entrez:
11
12
2022
pubmed:
12
12
2022
medline:
12
12
2022
Statut:
epublish
Résumé
Background: Simultaneous ulnar and radial artery compression (SURC) has emerged as a strategy to increase radial artery flow and mitigate radial artery occlusion (RAO) while achieving adequate hemostasis after transradial access (TRA), though its technical adoption has been limited worldwide. Methods: A systematic search of studies comparing SURC versus isolated radial artery compression after TRA for coronary angiography and/or intervention was performed. Data were pooled by meta-analysis using random-effects models. Odds ratios (OR) with relative 95% confidence intervals (CI) and standardized mean difference were used as measures of effect estimates. The primary endpoint was the occurrence of overall RAO. Results: A total of 6 studies and 6793 patients were included. SURC method as compared to isolated radial artery compression was associated with a lower risk of RAO both overall (OR 0.29; 95% CI, 0.13−0.61, p < 0.001; number needed to treat to benefit [NNTB] =38) and in-hospital (OR 0.28; 95% CI: 0.10 to 0.75; p = 0.01, NNTB = 36), with a reduced risk of unsuccessful patent hemostasis (OR: 0.13; 95% CI: 0.02 to 0.85; p = 0.03, NNT = 5) and upper extremity pain (OR: 0.48; 95% CI: 0.24 to 0.95; p = 0.04, NNTB = 124). No significant difference was observed in hemostasis time and in the risk of hematoma. Conclusion: Compared to isolated radial artery compression, SURC is associated with lower risk of RAO, unsuccessful patent hemostasis, and reported upper limb pain, without any trade-off in safety outcomes. With further development of dedicated dual compression devices, the proposed technique should be freed from usage constraints.
Identifiants
pubmed: 36498587
pii: jcm11237013
doi: 10.3390/jcm11237013
pmc: PMC9739321
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Catheter Cardiovasc Interv. 2016 Apr;87(5):868-74
pubmed: 26269451
J Clin Epidemiol. 2008 Jan;61(1):64-75
pubmed: 18083463
Cardiovasc Revasc Med. 2019 Aug;20(8):674-677
pubmed: 30245153
J Clin Med. 2019 Oct 18;8(10):
pubmed: 31635342
Circ Cardiovasc Interv. 2018 Sep;11(9):e000035
pubmed: 30354598
Catheter Cardiovasc Interv. 2022 Sep;100(3):387-391
pubmed: 35842777
JACC Cardiovasc Interv. 2016 Oct 10;9(19):1992-1999
pubmed: 27712733
Int J Cardiol. 2022 Sep 15;363:23-29
pubmed: 35714715
J Interv Cardiol. 2018 Dec;31(6):949-956
pubmed: 30168201
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
JACC Cardiovasc Interv. 2012 Jan;5(1):36-43
pubmed: 22230148
EuroIntervention. 2017 Aug 4;13(5):e549-e556
pubmed: 28218605
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
JACC Cardiovasc Interv. 2019 Nov 25;12(22):2235-2246
pubmed: 31753298
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Cardiovasc Diagn Ther. 2017 Jun;7(3):305-316
pubmed: 28567356
JACC Cardiovasc Interv. 2022 Nov 28;15(22):2297-2311
pubmed: 36423974
Circ Cardiovasc Interv. 2022 Apr;15(4):e011555
pubmed: 35317614
J Clin Epidemiol. 2008 Oct;61(10):991-6
pubmed: 18538991
Anesth Pain Med (Seoul). 2021 Apr;16(2):138-150
pubmed: 33940767
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
J Am Heart Assoc. 2016 Jan 25;5(1):
pubmed: 26811162
J Invasive Cardiol. 2020 Dec;32(12):476-482
pubmed: 32961529
J Biopharm Stat. 2005;15(5):823-38
pubmed: 16078388
Catheter Cardiovasc Interv. 2015 Jan 1;85(1):177
pubmed: 24740579
Medicine (Baltimore). 2015 Dec;94(52):e2170
pubmed: 26717360
J Clin Med. 2018 Oct 02;7(10):
pubmed: 30279350
J Invasive Cardiol. 2016 Nov;28(11):451-454
pubmed: 27529655
JACC Cardiovasc Interv. 2022 May 23;15(10):1022-1029
pubmed: 35589232