[A meta-analysis of randomized controlled trials comparing left with right radial approach for coronary angiography].
OBJECTIVE
To compare the efficacy between left radial approach (LRA) and right radial approach (RRA) for coronary angiography (CAG).


METHODS
The following databases were searched, including PubMed, Embase, Web of science, Cochrane Library, CBM, VIP, Wanfang databases and CNKI, from creation of database to January 2013. Two reviewers extracted data independently, according to inclusive criteria, exclusion criteria and methods of Cochrane Collaboration. Statistical analysis was performed using Review Manager Software (RevMan 5.1).


RESULTS
Eleven trials with 5 442 patients were included in the systematic review. The results of meta-analysis showed that when compared with RRA, LRA did not increase the failure rate of the procedures (OR = 1.04, 95%CI 0.80-1.35, P > 0.05) and amount of contrast medium (mean difference = 2.39, 95%CI -0.30-5.08), P > 0.05). However, LRA was superior to RRA in reducing fluoroscopy time (standardized mean difference = 0.15, 95%CI 0.06-0.24, P < 0.01). In addition, the incidence of severe tortuosity of subclavian artery was significantly lower with LRA (OR = 4.65, 95%CI 1.98-10.88, P < 0.01).


CONCLUSIONS
Based on the current evidence, LRA shares similar safety with RRA for CAG and is superior to RRA in certain respects. LRA can thus be used either as an alternative approach or routine approach for CAG.
First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
Xiaowei
X
Niu
Cuiling
C
Yang
Shengliang
S
He
De
D
Chen
Dong
D
Yan
Zhiyu
Z
He
Email: yaoyalifs@163.com.
Yali
Y
Yao
D017023:Coronary Angiography / Q000379:methods*; D006801:Humans; D017534:Radial Artery; D016032:Randomized Controlled Trials as Topic