Coronary artery disease · 2025
Radial artery occlusion after cardiac catheterization and impact of anticoagulation as medical treatment: a meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Didagelos Matthaios, Papazoglou Andreas S, Moysidis Dimitrios V, Pagiantza Areti, Afendoulis Dimitrios, Kakderis Charalambos, Daios Stylianos, Anastasiou Vasileios, Theodoropoulos Konstantinos C, Kouparanis Antonios, Kartalis Athanasios, Kamperidis Vasileios, Kassimis George, Ziakas Antonios
Аннотация
BACKGROUND: Radial artery occlusion (RAO) is one of the most common complications associated with transradial access in cardiac catheterization procedures. To date there are no standardized protocols, and only a few studies have evaluated the use of anticoagulation for RAO treatment. The current meta-analysis aimed to assess the impact of various anticoagulation strategies on RAO treatment after cardiac catheterization via the transradial route.
METHODS: Literature search was performed in PubMed, Web of Science, and CENTRAL databases, from inception until September 2024. The primary outcome of this study was the incidence of radial artery recanalization. The secondary outcomes were the incidence of any bleeding events and symptom resolution during patient follow-up.
RESULTS: A total of six studies with 398 patients were included in the analysis. Patients with RAO under anticoagulation had a sevenfold increased chance of radial artery recanalization [pooled odds ratio (pOR) = 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there was no statistically significant difference between patients receiving and not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41]. Regarding bleeding events, no pooled data could be extracted; however, no major bleeding events were reported in any study.
CONCLUSION: This meta-analysis provides compelling evidence that anticoagulation therapy significantly improves radial artery recanalization rates in patients with RAO without increasing the risk of major bleeding events; however, its effect on symptom resolution remains limited, suggesting the need for a comprehensive approach to RAO management.
METHODS: Literature search was performed in PubMed, Web of Science, and CENTRAL databases, from inception until September 2024. The primary outcome of this study was the incidence of radial artery recanalization. The secondary outcomes were the incidence of any bleeding events and symptom resolution during patient follow-up.
RESULTS: A total of six studies with 398 patients were included in the analysis. Patients with RAO under anticoagulation had a sevenfold increased chance of radial artery recanalization [pooled odds ratio (pOR) = 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there was no statistically significant difference between patients receiving and not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41]. Regarding bleeding events, no pooled data could be extracted; however, no major bleeding events were reported in any study.
CONCLUSION: This meta-analysis provides compelling evidence that anticoagulation therapy significantly improves radial artery recanalization rates in patients with RAO without increasing the risk of major bleeding events; however, its effect on symptom resolution remains limited, suggesting the need for a comprehensive approach to RAO management.