Author + information
- Arun Kanmanthareddy1,
- Avanija Buddam2,
- Satish Chandraprakasam1,
- Madhu Reddy2,
- Dhanunjaya Lakkireddy2,
- Claire Hunter1 and
- Venkata Alla1
Transradial access for coronary angiography is widely used because of the low risk of complications and faster ambulation times for patients. Ulnar artery can also be easily accessed for coronary angiography. We compared the safety and efficacy of this approach in this meta-analysis.
PubMed, EBSCO and Google Scholar databases were queried for studies on transradial and transulnar access. Efficacy and adverse events for both these routes were then extracted and analyzed with Revman 5.2 software using random effects model.
A total of 7 studies with 13,285 patients were included in this meta-analysis. There was a high percentage of successful radial artery access with a very low risk of crossover to alternate site compared to ulnar artery access (OR 0.32, 95% CI 0.12-0.91). This was driven by a high crossover rate in the ulnar group in one particular study. The number of attempts needed to gain successful access was very similar between the two groups (mean difference = -0.18, 95% CI -0.27-0.09). The incidence of complications such as hematomas (OR 0.81, 95% CI 0.41-1.61), arterial spasm (OR 1.21, 95% CI, 0.47-3.14), arterial occlusion (OR 0.93, 95% CI 0.68-1.28) and major adverse cardiovascular events (OR 1.17, 95% CI 0.73-1.86) were similar in both groups.
There was a lower incidence of crossover with the radial access compared to ulnar. However, the complication rates were similar between the two groups.