• Giuseppe Biondi-Zoccai, Alessandro Sciahbasi, Vicente Bodí, Javier Fernández-Portales, Yumiko Kanei, Enrico Romagnoli, Pierfrancesco Agostoni, Giuseppe Sangiorgi, Marzia Lotrionte, and Maria Grazia Modena.
• Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy. gbiondizoccai@gmail.com
• Int. J. Cardiol. 2013 Jul 1;166(3):621-6.

BackgroundRadial artery access is a mainstay in the diagnosis and treatment of coronary artery disease. However, there is uncertainty on the comparison of right versus left radial access for coronary procedures. We thus undertook a systematic review and meta-analysis comparing right versus left radial access for coronary diagnostic and interventional procedures.MethodsPertinent studies were searched in CENTRAL, Google Scholar, MEDLINE/PubMed, and Scopus, together with international conference proceedings. Randomized trials comparing right versus left radial (or ulnar) access for coronary diagnostic or interventional procedures were included. Risk ratios (RR) and weighted mean differences (WMD) were computed to generate point estimates (95% confidence intervals).ResultsA total of 5 trials (3210 patients) were included. No overall significant differences were found comparing right versus left radial access in terms of procedural time (WMD=0.99 [-0.53; 2.51]min, p=0.20), contrast use (WMD=1.71 [-1.32; 4.74]mL, p=0.27), fluoroscopy time (WMD=-35.79 [-3.54; 75.12]s, p=0.07) or any major complication (RR=2.00 [0.75; 5.31], p=0.49). However, right radial access was fraught with a significantly higher risk of failure leading to cross-over to femoral access (RR=1.65 [1.18; 2.30], p=0.003) in comparison to left radial access.ConclusionsRight and left radial accesses appear largely similar in their overall procedural and clinical performance during transradial diagnostic or interventional procedures. Nonetheless, left radial access can be recommended especially during the learning curve phase to reduce femoral cross-overs.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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