Objectives. Searching the literature for coronary angiography (CAG) or intervention through distal radial access (DRA) and performing a meta-analysis. Background. Coronary angiography (CAG) or intervention through distal radial access (DRA) may have a similar success rate, low radial artery occlusion rate, low radial artery spasm rate, and low rate of puncture site hematoma for patients with coronary heart disease. Therefore, the randomized controlled trials (RCTs) were searched, and the data were pooled for meta-analysis to evaluate the effectiveness and safety of DRA. Methods. RCTs comparing the CAG or intervention through DRA vs. transradial access (TRA) published between January 1, 2017, and May 4, 2021, were searched in the PubMed, Embase, and Cochrane databases. The endpoints included the rate of access success and the number of radial artery occlusions, radial artery spasms, and puncture site hematomas. The data were extracted, and a random-effects model was used for analysis. Results. Among 204 studies, 6 RCTs (with 2825 participants) met the inclusion criteria. Compared to TRA, the access success rate in DRA () and the lower rate of puncture site hematoma were not significantly different (), while the radial artery occlusion rate () and radial artery spasm rate () were significantly lower. Conclusion. In summary, DRA has a similar access success rate and incidence of hematoma at the puncture site, but a lower incidence of RAO and spasm compared to TRA. These findings demonstrated that DRA is a safe and effective access for CAG or intervention.

中文翻译：

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通过远端桡动脉通路进行冠状动脉造影或干预的安全性和有效性：荟萃分析

目标。搜索冠状动脉造影 (CAG) 或通过远端桡动脉 (DRA) 进行干预的文献并进行荟萃分析。背景。对于冠心病患者，冠状动脉造影（CAG）或通过远端桡动脉介入（DRA）可能具有相似的成功率、低桡动脉闭塞率、低桡动脉痉挛率和低穿刺部位血肿率。因此，对随机对照试验（RCT）进行了检索，并汇总数据进行荟萃分析，以评估 DRA 的有效性和安全性。方法. 在 PubMed、Embase 和 Cochrane 数据库中检索了 2017 年 1 月 1 日至 2021 年 5 月 4 日期间发表的比较 CAG 或 DRA 干预与经桡动脉通路 (TRA) 干预的 RCT。终点包括通路成功率和桡动脉闭塞、桡动脉痉挛和穿刺部位血肿的数量。提取数据，并使用随机效应模型进行分析。结果。在 204 项研究中，6 项 RCT（2825 名受试者）符合纳入标准。与 TRA 相比，DRA 的访问成功率 (）和较低的穿刺部位血肿发生率无显着差异（),而桡动脉闭塞率 ()和桡动脉痉挛率 ()显着降低。结论。综上所述，与 TRA 相比，DRA 的穿刺成功率和血肿发生率相似，但 RAO 和痉挛的发生率较低。这些发现表明，DRA 是一种安全有效的 CAG 或干预途径。