The efficacy and safety of transradial and transfemoral approach in treatment of coronary chronic total occlusion: a systematic review and meta-analysis

The clinical efficacy and safety of transradial (TR) percutaneous coronary intervention (PCI) in comparison to transfemoral (TF) for chronic total occlusion (CTO) is not well studied in literature. <b>Objectives</b>: We sought to study the outcome and complications associated with TR compared with TF for CTO interventions. After a systematic literature search was done in PubMed and EMBASE, we performed a meta-analysis of studies comparing TF and TR for CTO PCI. <b>Results</b>: Twelve studies with 19,309 patients were included. Compared to those who has TF access, individuals who were treated via TR approach had statistically significant lower access complication rates [odds ratio (OR): 0.33; 95% confidence interval (CI): 0.22 to 0.49; p When compared with TF access interventions in CTO PCI; the TR approach appears to be associated with far less access-site complications, higher procedural success, and comparable MACCE.

经桡动脉（transradial, TR）入路经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）对比经股动脉（transfemoral, TF）入路治疗慢性完全闭塞（chronic total occlusion, CTO）的临床疗效与安全性，目前在学术文献中尚未得到充分探讨。**研究目的**：本研究旨在对比经桡动脉入路与经股动脉入路用于慢性完全闭塞介入治疗的临床结局与并发症情况。研究团队在PubMed与EMBASE数据库中完成系统性文献检索后，针对对比经股动脉与经桡动脉入路行CTO PCI的相关研究开展了Meta分析。**研究结果**：本研究共纳入12项相关研究，涉及19309例患者。与接受经股动脉入路治疗的患者相比，采用经桡动脉入路治疗的患者其血管入路并发症发生率显著降低[比值比（odds ratio, OR）=0.33；95%置信区间（confidence interval, CI）：0.22~0.49；p]。与经股动脉入路的CTO PCI手术相比，经桡动脉入路似乎可显著减少血管入路部位并发症、提升手术成功率，且主要不良心脑血管事件（major adverse cardiac and cerebrovascular events, MACCE）的发生率相当。