经桡动脉途径行冠状动脉造影时，第二代老虎导管与Judkins导管的比较疗效和安全性：一项荟萃分析。

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

作者信息

Aljabali Ahmed, Alawajneh Mohmmad M, Hammad Arafat, Nguyen Danh, Alkasabrah Abdel Rahman, Abuein Khaled, Altibi Ahmed M

机构信息

Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.

出版信息

Acta Cardiol. 2025 Feb;80(1):39-43. doi: 10.1080/00015385.2024.2442799. Epub 2025 Jan 9.

DOI:10.1080/00015385.2024.2442799

PMID:39781598

Abstract

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], < 0.01), procedural time (MD = -2.00 min, 95% CI [-2.35, -1.66], < 0.01), and contrast volume (MD = -7.48 ml, 95% CI [-12.66, -2.29], < 0.01). Radial artery spasm incidence was also lower (OR = 0.30, 95% CI [0.12, 0.75], = 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.

摘要

背景

与经股动脉途径相比，经桡动脉冠状动脉造影术（TR-CAG）因并发症发生率较低而越来越受欢迎。操作者可以使用传统导管，如Judkins导管，或专用单导管，如Tiger-II导管。本荟萃分析比较了Tiger-II导管与Judkins导管在TR-CAG中的安全性和有效性。

方法

我们检索了截至2024年2月的PubMed、Web of Science、Scopus和Cochrane图书馆，以查找比较Tiger-II导管和Judkins导管在TR-CAG中的研究。固定效应模型和随机效应模型汇总了比值比（OR）和标准化均值差（SMD）的估计值。主要结局包括透视时间和造影剂用量。次要结局包括手术时间、辐射暴露、手术成功率、桡动脉痉挛和交叉率。

结果

纳入了7项研究，共2879例患者（Tiger-II组1799例，Judkins组1080例）。使用Tiger-II导管可显著缩短透视时间（SMD = -0.50分钟，95%可信区间[-0.80, -0.19]，P < 0.01）、手术时间（MD = -2.00分钟，95%可信区间[-2.35, -1.66]，P < 0.01）和造影剂用量（MD = -7.48毫升，95%可信区间[-12.66, -2.29]，P < 0.01）。桡动脉痉挛发生率也较低（OR = 0.30，95%可信区间[0.12, 0.75]，P = 0.01）。辐射暴露、手术成功率或交叉率无显著差异。