VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA.
Int J Cardiol. 2013 Oct 15;168(6):5234-8. doi: 10.1016/j.ijcard.2013.08.026. Epub 2013 Aug 14.
Transradial (TR) catheterization is gaining popularity due to its association with lower bleeding and access site complications, improved patient comfort, and lower costs compared to transfemoral (TF) catheterization; however, there is concern that TR catheterization may be associated with an increased risk of neurological complications. New randomized data has emerged since the publication of the last meta-analysis evaluating the risk of stroke between TR and TF catheterization in 2009.
We conducted a meta-analysis of randomized studies published until 2013 reporting risk of stroke in TR vs. TF catheterization.
Data from 11,273 patients in 13 studies were collated. The majority of patients were men, and 8987 (79.7%) were enrolled in acute coronary syndrome trials. Very few patients had a history of prior coronary artery bypass grafting, and approximately 2/3 of patients underwent percutaneous coronary intervention. Stroke occurred in 25 of 5659 patients in the TR group, vs. 24 of 5614 patients in the TF group. There was no difference in stroke rates between the TR and TF groups (risk difference 0.00%, 95% confidence interval -0.29%-0.25%, p=0.88).
TR catheterization is not associated with a significant increase in stroke compared to TF catheterization.
与经股动脉（TF）入路相比，经桡动脉（TR）入路因出血和入路部位并发症较少、患者舒适度提高、成本降低而越来越受欢迎；然而，人们担心 TR 入路可能与神经并发症风险增加有关。自 2009 年发表最后一次评估 TR 和 TF 入路在卒中风险方面的荟萃分析以来，已经出现了新的随机数据。
我们对截至 2013 年发表的评价 TR 与 TF 入路在卒中风险方面的随机研究进行了荟萃分析。
共汇总了 13 项研究的 11273 例患者的数据。大多数患者为男性，8987 例（79.7%）患者入组急性冠脉综合征试验。既往冠状动脉旁路移植术病史的患者很少，约 2/3 的患者接受经皮冠状动脉介入治疗。TR 组 5659 例患者中有 25 例发生卒中，TF 组 5614 例患者中有 24 例发生卒中。TR 组和 TF 组的卒中发生率无差异（风险差 0.00%，95%置信区间-0.29%至-0.25%，p=0.88）。
与 TF 入路相比，TR 入路与卒中风险增加无关。
