The comparison of efficacy and safety between transradial and transfemoral approach for chronic total occlusions intervention: a meta-analysis

• Published in: Scientific reports Vol. 12; no. 1; p. 7591
• Main Authors: Lee, Wei-Chieh, Wu, Po-Jui, Fang, Chih-Yuan, Fang, Hsiu-Yu, Wu, Chiung-Jen, Liu, Ping-Yen
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.05.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019; 692/4019/2776; 692/700; Chronic Disease; Coronary Angiography; Coronary artery; Coronary Occlusion - diagnostic imaging; Coronary Occlusion - surgery; Coronary vessels; Femoral Artery - surgery; Fluoroscopy; Hospital Mortality; Humanities and Social Sciences; Humans; Meta-analysis; multidisciplinary; Observational studies; Occlusion; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Radial Artery - surgery; Risk Factors; Science; Science (multidisciplinary); Success; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-11763-y

This meta-analysis compared the outcomes of transradial access (TRA) and transfemoral access (TFA) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in recent decades. We searched multiple databases for articles published between January 1, 2015, and December 31, 2020. Six observational studies with 11,736 patients were analyzed. Data included baseline demographics, Japan-chronic total occlusion (J-CTO) score, sheath size, PCI vessel, retrograde method, procedural time, fluoroscopy time, and contrast volume. The more prevalent target CTO vessel was the left coronary artery in the TRA group and the right coronary artery in the TFA group. Higher J-CTO score, longer procedural time, and more contrast volume were seen in the TFA group. In comparison, the TRA group had better procedural success rate (odds ratio (OR), 0.846; 95% confidence interval (CI) 0.749–0.956) and less vascular complications (OR, 0.323; 95% CI 0.203–0.515), but similar retrograde success rate (OR, 0.965; 95% CI 0.382–2.435). In-hospital death (OR, 0.527; 95% CI 0.187–1.489) and major adverse cardiovascular events (OR, 0.729; 95% CI 0.504–1.054) did not differ between the groups. Overall, fewer vascular complications and higher procedural success rates were noted in the TRA CTO PCI population. However, similar retrograde success rates and clinical outcomes were noted between the groups.