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Transradial versus transfemoral percutaneous coronary intervention of left main disease: A systematic review and meta‐analysis of observational studies
Author(s) -
Ando Tomo,
Aoi Shunsuke,
Ashraf Said,
Villablanca Pedro A.,
Telila Tesfaye,
Briasoulis Alexandros,
Takagi Hisato,
Afonso Luis,
Grines Cindy L.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28025
Subject(s) - conventional pci , medicine , percutaneous coronary intervention , meta analysis , confidence interval , cardiology , myocardial infarction , odds ratio , coronary artery disease , revascularization , stent , surgery
Objectives To assess the efficacy and safety of transradial (TR) versus transfemoral (TF) percutaneous coronary intervention (PCI) in left main (LM) lesion. Background TR‐PCI is the preferred approach compared with TF approach because of less bleeding risk. LM‐PCI is often challenging because of the anatomical complexity and uniqueness of supplying a large myocardium territory. We performed a systematic review and meta‐analysis to assess the safety and efficacy of TR‐PCI compared with TF‐PCI of the LM lesions. Methods A comprehensive literature search of PUBMED, EMBASE, and Cochrane database was conducted to identify studies that reported the comparable outcomes between both approaches. Odds ratio (OR) and 95% confidence interval (CI) was calculated using the Mantel–Haenszel method. Results A total of eight studies were included in the quantitative meta‐analysis. TR‐PCI resulted in lower bleeding risk (OR 0.31, 95%CI 0.18–0.52, P < 0.01, I 2 = 0%) while maintaining similar procedural success rate, target lesion revascularization, myocardial infarction, stent thrombosis, and all‐cause mortality during the study follow‐up period. Conclusions TR‐PCI may achieve similar efficacy with decreased bleeding risk compared to TF‐PCI in LM lesions. When operator experience and anatomical complexity are favorable, TR approach is an attractive alternative access over TF approach in LM‐PCI.