Transradial versus transfemoral percutaneous coronary intervention of left main disease: A systematic review and meta‐analysis of observational studies

摘要

Abstract 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.