[1]王鹏飞,高丽华,史文册,等.经远端桡动脉与经传统桡动脉入路行冠状动脉介入诊疗RCT研究的Meta分析[J].医学信息,2024,37(15):21-26.[doi:10.3969/j.issn.1006-1959.2024.15.005]
　WANG Peng-fei,GAO Li-hua,SHI Wen-ce,et al.Meta-analysis of RCT Studies on Coronary Intervention Through Distal Radial Artery and Traditional Radial Artery Approach[J].Journal of Medical Information,2024,37(15):21-26.[doi:10.3969/j.issn.1006-1959.2024.15.005]
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经远端桡动脉与经传统桡动脉入路行冠状动脉介入诊疗RCT研究的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年15期
页码:
21-26
栏目:
医学数据科学
出版日期:
2024-08-01

文章信息/Info

Title:
Meta-analysis of RCT Studies on Coronary Intervention Through Distal Radial Artery and Traditional Radial Artery Approach
文章编号:
1006-1959（2024）15-0021-06
作者:
王鹏飞; 高丽华; 史文册; 等
（航天中心医院心脏医学部，北京 100049）
Author(s):
WANG Peng-fei; GAO Li-hua; SHI Wen-ce; et al.
(Department of Cardiology,Aerospace Center Hospital,Beijing 100049,China)
关键词:
桡动脉; 远端桡动脉; 冠状动脉介入诊疗
Keywords:
Radial artery; The distal radial artery; Percutaneous coronary intervention
分类号:
R541.4
DOI:
10.3969/j.issn.1006-1959.2024.15.005
文献标志码:
A
摘要:
目的 应用Meta分析评估冠状动脉介入诊疗中经远端桡动脉入路与经桡动脉入路穿刺成功率、穿刺时间及穿刺并发症发生率。方法 使用计算机检索PubMed、EMbase、Cochrane Library、中国生物医学服务系统（Si-nomed）、中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普（VIP）等数据库。由3名研究员独立收集数据，2名研究者评估数据内容并使用RevMan5.3软件进行Meta分析。结果 共纳入12篇RCT研究，共4886例患者。与经传统桡动脉穿刺入路相比，经远端桡动脉入路穿刺成功率较低（OR=6.73，95%CI：4.58~9.90，P＜0.000 01，Z=9.69），一次穿刺成功率较低（OR=2.86，95%CI：2.37~3.45，P＜0.000 01，Z=10.96），穿刺时间更长（OR=0.73，95%CI：0.40~1.06，P＜0.0001，Z=4.30），远端桡动脉入路的闭塞率较低（OR=0.25，95%CI：0.18~0.35，P＜0.000 01，Z=7.98）；两组局部血肿（OR=0.88，95%CI：0.64~1.21，P=0.43，Z=0.80）、桡动脉痉挛（OR=1.00，95%CI：0.62~1.61，P=0.99，Z=0.01）比较，差异无统计学意义。结论 与传统桡动脉入路相比，经远端桡动脉入路在行冠脉介入诊疗时穿刺成功率较低、穿刺时间较长，局部血肿及桡动脉痉挛发生率无明显变化，但可有效避免桡动脉闭塞。
Abstract:
Objective To evaluate the success rate, puncture time and incidence of puncture complications between distal radial artery approach and transradial artery approach in coronary intervention by Meta-analysis.Methods PubMed, EMbase, Cochrane Library, Si-nomed, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP and other databases were searched by computer. Three researchers independently collected data, and two researchers assessed the data content and used RevMan5.3 software for meta-analysis.Results A total of 12 RCT studies involving 4886 patients were included. Compared with the traditional radial artery puncture approach, the success rate of distal radial artery puncture was lower (OR=6.73, 95%CI: 4.58-9.90, P<0.000 01, Z=9.69), the success rate of one-time puncture was lower (OR=2.86, 95%CI: 2.37-3.45, P<0.000 01, Z=10.96), and the puncture time was longer (OR=0.73, 95%CI: 0.40-1.06, P<0.0001, Z=4.30), the occlusion rate of distal radial artery approach was lower (OR=0.25, 95%CI: 0.18-0.35, P<0.000 01, Z=7.98). There was no significant difference in local hematoma (OR=0.88,95%CI: 0.64-1.21, P=0.43, Z=0.80) and radial artery spasm (OR=1.00, 95%CI: 0.62-1.61, P=0.99, Z=0.01) between the two groups.Conclusion Compared with the traditional radial artery approach, the distal radial artery approach has a lower puncture success rate and a longer puncture time during coronary intervention. There is no significant change in the incidence of local hematoma and radial artery spasm, but it can effectively avoid radial artery occlusion.

参考文献/References:

[1]Kiemeneij F,Laarman GJ.Percutaneous transradial artery approach for coronary Palmaz-Schatz stent implantation[J].Am Heart J,1994,128(1):167-174.[2]Hamon M,Pristipino C,Di Mario C,et al.Consensus document on the radial approach in percutaneous cardiovascular interventions:position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology[J].EuroIntervention,2013,8(11):1242-1251.[3]Kiemeneij F.Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI)[J].EuroIntervention,2017,13(7):851-857.[4]Prasad RM,Pandrangi P,Pandrangi G,et al.Meta-Analysis Comparing Distal Radial Artery Approach Versus Traditional for Coronary Procedures[J].Am J Cardiol,2022,164:52-56.[5]Mhanna M,Beran A,Nazir S,et al.Outcomes of distal versus conventional transradial access for coronary angiography and intervention: An updated systematic review and meta-analysis[J].Int J Cardiol,2021,344:47-53.[6]Cao J,Cai H,Liu W,et al.Safety and Effectiveness of Coronary Angiography or Intervention through the Distal Radial Access: A Meta-Analysis[J].J Interv Cardiol,2021,2021:4371744.[7]Tsigkas G,Papageorgiou A,Moulias A,et al.Distal or Traditional Transradial Access Site for Coronary Procedures: A Single-Center, Randomized Study[J].JACC Cardiovasc Interv,2022,15(1):22-32.[8]Eid-Lidt G,Rivera Rodríguez A,Jimenez Castellanos J,et al.Distal Radial Artery Approach to Prevent Radial Artery Occlusion Trial[J].JACC Cardiovasc Interv,2021,14(4):378-385.[9]Koledinskiy AG,Mikheeva YUV,Ogurtsov PP,et al.Hospital results of endovascular treatment of patients with Acute Coronary Syndrome (ACS) through distal radial access[J].European Heart Journal,2020,41(Supplement_2):ehaa946.2498.[10]Koutouzis M,Kontopodis E,Tassopoulos A,et al.Distal Versus Traditional Radial Approach for Coronary Angiography[J].Cardiovasc Revasc Med,2019,20(8):678-680.[11]Lin Y,Sun X,Chen R,et al.Feasibility and Safety of the Distal Transradial Artery for Coronary Diagnostic or Interventional Catheterization[J].J Interv Cardiol,2020,2020:4794838.[12]Lu H,Wu D,Chen X.Comparison of Distal Transradial Access in Anatomic Snuffbox Versus Transradial Access for Coronary Angiography[J].Heart Surg Forum,2020,23(4):E407-E410.[13]Mokbel M,Sinescu C,Florescu N.P4398 Snuff-box versus distal forearm for trans-radial access: performance and radial patency[J].European Heart Journal,2018,39(suppl_1):ehy563.P4398.[14]Sanhoury MI,Sobhy MA,Saddaka MA,et al.Distal radial approach between theory and clinical practice.. Time to go distal![J].Egypt Heart J,2022,74(1):8.[15]Sharma AK,Razi MM,Prakash N,et al.A comparative assessment of Dorsal radial artery access versus classical radial artery access for percutaneous coronary angiography-a randomized control trial (DORA trial)[J].Indian Heart J,2020,72(5):435-441.[16]付小琴,李兴革.桡动脉远端穿刺在经皮冠状动脉介入治疗中的整体应用效果及安全性分析[J].中外医学研究,2021,19(36):138-141.[17]刘玉文,钱进,王能,等.经远端桡动脉行冠状动脉介入治疗的可行性及安全性研究[J].微循环学杂志,2020,30(2):39-43.[18]欣明花,钟诚,许峥贵,等.经远端桡动脉腕背支穿刺途径在冠状动脉介入诊治中的效果及安全性评价[J].浙江医学,2020,42(15):1633-1637.[19]Tomey MI,Tamis-Holland JE.Distal Radial Artery Access: Fad or New Frontier?[J].JACC CardiovascInterv,2022,15(22):2312-2314.[20]Lee JW,Son JW,Go TH,et al.Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment[J].Korean J Intern Med,2022,37(1):109-118.[21]Norimatsu K,Kusumoto T,Yoshimoto K,et al.Importance of measurement of the diameter of the distal radial artery in a distal radial approach from the anatomical snuffbox before coronary catheterization[J].Heart Vessels,2019,34(10):1615-1620.[22]Demirk?覦ran A,Ayd?覦n C.Methods for increasing distal radial artery diameter[J].Eur Rev Med Pharmacol Sci,2023,27(5):1875-1880.[23]Roh JW,Kim Y,Lee OH,et al.The learning curve of the distal radial access for coronary intervention[J].Sci Rep,2021,11(1):13217.[24]Achim A,Péter Oá,Kákonyi K,et al.The Role of Ultrasound in Accessing the Distal Radial Artery at the Anatomical Snuffbox for Cardiovascular Interventions[J].Life (Basel),2022,13(1):25.[25]Pacchioni A,Mugnolo A,Sanz Sanchez J,et al.Radial artery occlusion after conventional and distal radial access: Impact of preserved flow and time-to-hemostasis in a propensity-score matching analysis of 1163 patients[J].Catheter Cardiovasc Interv,2022,99(3):827-835.[26]Sgueglia GA,Hassan A,Harb S,et al.International Hand Function Study Following Distal Radial Access:The RATATOUILLE Study[J].JACC Cardiovasc Interv,2022,15(12):1205-1215.

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更新日期/Last Update: 1900-01-01