Comparison of Radiation Exposure to X-Ray Between Left and Right Radial Approach During Coronary Procedures: A Meta-Analysis Based on Randomized Controlled Trials.

To conduct a meta-analysis to investigate the X-ray radiation exposure between left and right radial approach (LRA/RRA) during percutaneous coronary procedures. A systematic literature search from the inception of Scopus, Embase, Pubmed, and Web of science databases were systematic searched until July 2025 was performed for studies that compared the radiation exposure between LRA and RRA. 19 randomized controlled trials (RCTs) with 9443 individuals were included in our meta-analysis. The overall effect showed a significantly reduction in fluoroscopy time (FT) and dose area product (DAP) for the LRA group compared to the RRA group (standardized mean difference [SMD] 0.105, 95% confidence interval [CI]: 0.037-0.174, I2 = 54.9%, p = 0.003; SMD 0.09, 95% CI: 0.016-0.163, I2 = 51.3%, p = 0.017). The pooled results did not show any significant different of cumulative air kerma (CAK) between RRA group and LRA group during percutaneous coronary procedure (SMD 0.067, 95% CI: -0.001 TO 0.135, I2 = 22.5%, p = 0.055). Both the operator's radiation dose and the DAP-normalized thorax dose were significantly lower with LRA compared to RRA during percutaneous coronary procedure (SMD 0.297, 95% CI: 0.023-0.71, I2 = 84.4%, p = 0.034; SMD 0.392, 95% CI: 0.251-0.533, I2 = 0%, p = 0.000). The LRA was associated with a significant reduction in FT, DAP and the operator's radiation exposure compared to the RRA during percutaneous coronary procedures.