Efficacy and Safety of Left versus Right Radial Approach for Percutaneous Coronary Procedures: A Meta-Analysis

Objective To assess the efficacy and safety of left （LRA） versus right radial approach （RRA） for coronary diagnostic or interventional procedures. Methods The databases were searched including PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang. Two reviewers extracted data independently according to the methods of Cochrane Collaboration. Statistical analysis was performed using Review Manager software （RevMan 5.1, Cochrane Collaboration, Oxford, UK）. Results 13 trials with 6 605 patients were included in the meta-analysis. The results showed no significant difference in the risks of peripheral vascular complications and major adverse cardiac events comparing LRA with RRA （P>0.05）. However, in comparison with LRA, RRA arm was fraught with a significantly higher risk of failure leading to cross-overs to other access risk ratio 1.37, 95% confidence interval （1.10,1.71）, P=0.005, and a prolonged procedural time mean difference 0.73, 95% confidence interval （0.09,1.36）, P=0.02. Conclusions Compared with RRA, LRA could reduce the risk of other access cross-overs and the procedural time. LRA could be recommended to complete coronary intervention for operators during the learning curve phase.