The comparative efficacy and safety of Tiger II versus judkins catheters in coronary angiogram via the radial artery access: a meta-analysis.

BACKGROUND

Trans-radial coronary angiogram (TR-CAG) has gained popularity due to lower complication rates compared to transfemoral access. Operators can use either conventional catheters, such as Judkins, or single dedicated catheters, such as Tiger-II. This meta-analysis compared the safety and efficacy of Tiger-II versus Judkins catheters in TR-CAG.

METHODS

We searched PubMed, Web of Science, Scopus, and Cochrane Library through February 2024 for studies comparing Tiger-II and Judkins catheters in TR-CAG. Fixed- and random-effect models pooled estimates of odds ratios (ORs) and standardised mean differences (SMDs). Primary outcomes included fluoroscopy time and contrast volume. Secondary outcomes included procedural time, radiation exposure, procedural success, radial artery vasospasm, and crossover rate.

RESULTS

Seven studies with 2879 patients (1799 in Tiger-II and 1080 in Judkins) were included. Tiger-II use significantly reduced fluoroscopy time (SMD = -0.50 min, 95% CI [-0.80, -0.19], p < 0.01), procedural time (MD = -2.00 min, 95% CI [-2.35, -1.66], p < 0.01), and contrast volume (MD = -7.48 ml, 95% CI [-12.66, -2.29], p < 0.01). Radial artery spasm incidence was also lower (OR = 0.30, 95% CI [0.12, 0.75], p = 0.01). There were no significant differences in radiation exposure, procedural success, or crossover rate.

CONCLUSION

Tiger-II catheters offer reduced fluoroscopy time, procedural time, contrast volume, and radial artery spasm rates in TR-CAG.