<b>Distal transradial approach reduced the incidence of radial artery occlusion for</b><b>coronary diagnostic</b><b>or interventional catheterization compared with conventional transradial approach: a meta-analysis</b>

Introduction: This meta-analysis seeks to evaluate the efficacy and safety of distal transradial approach (dTRA) in coronary diagnostic or interventional catheterization compared with conventional transradial approach (cTRA).Materials and methods: Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from the establishment of the databases to April 13, 2024, for articles studying dTRA compared to cTRA in coronary diagnostic or interventional catheterization. Meta-analyses of radial artery occlusion (RAO), procedure success, successful catheter puncture, puncture in a single attempt, hematoma, radial artery spasm, puncture point bleeding, puncture time, procedural time, dosage of contrast medium, and hemostasis time.Results: Totally 31 studies were included for meta-analysis. Compared with cTRA, dTRA significantly reduced the incidence of RAO (OR = 0.41, 95% CI: 0.34, 0.50, P<0.00001), hematoma (OR=0.67, 95%CI:0.56,0.80, P<0.0001) and short hemostasis time (MD=-0.43, 95%CI:-0.65,-0.20,P=0.0002), but had significantly low procedure success (OR=0.41, 95%CI:0.30,0.56,P<0.00001), low successful catheter puncture (OR=0.44, 95%CI:0.27,0.71,P=0.0009) and longer puncture time (MD=0.60, 95%CI:0.44,0.75,P<0.00001). There was no significant difference in puncture in a single attempt, radial artery spasm, puncture point bleeding, procedural time, dosage of contrast medium.