Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis
Background: Simultaneous ulnar and radial artery compression (SURC) has emerged as a strategy to increase radial artery flow and mitigate radial artery occlusion (RAO) while achieving adequate hemostasis after transradial access (TRA), though its technical adoption has been limited worldwide. Method...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/7013 |
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| author | Francesco Condello Michele Cacia Matteo Sturla Riccardo Terzi Jorge Sánz-Sanchez Bernhard Reimers Gabriele L. Gasparini Paolo Pagnotta Sabato Sorrentino Carmen Spaccarotella Ciro Indolfi Alberto Polimeni |
| author_facet | Francesco Condello Michele Cacia Matteo Sturla Riccardo Terzi Jorge Sánz-Sanchez Bernhard Reimers Gabriele L. Gasparini Paolo Pagnotta Sabato Sorrentino Carmen Spaccarotella Ciro Indolfi Alberto Polimeni |
| author_sort | Francesco Condello |
| collection | DOAJ |
| description | Background: Simultaneous ulnar and radial artery compression (SURC) has emerged as a strategy to increase radial artery flow and mitigate radial artery occlusion (RAO) while achieving adequate hemostasis after transradial access (TRA), though its technical adoption has been limited worldwide. Methods: A systematic search of studies comparing SURC versus isolated radial artery compression after TRA for coronary angiography and/or intervention was performed. Data were pooled by meta-analysis using random-effects models. Odds ratios (OR) with relative 95% confidence intervals (CI) and standardized mean difference were used as measures of effect estimates. The primary endpoint was the occurrence of overall RAO. Results: A total of 6 studies and 6793 patients were included. SURC method as compared to isolated radial artery compression was associated with a lower risk of RAO both overall (OR 0.29; 95% CI, 0.13–0.61, <i>p</i> < 0.001; number needed to treat to benefit [NNTB] =38) and in-hospital (OR 0.28; 95% CI: 0.10 to 0.75; <i>p</i> = 0.01, NNTB = 36), with a reduced risk of unsuccessful patent hemostasis (OR: 0.13; 95% CI: 0.02 to 0.85; <i>p</i> = 0.03, NNT = 5) and upper extremity pain (OR: 0.48; 95% CI: 0.24 to 0.95; <i>p</i> = 0.04, NNTB = 124). No significant difference was observed in hemostasis time and in the risk of hematoma. Conclusion: Compared to isolated radial artery compression, SURC is associated with lower risk of RAO, unsuccessful patent hemostasis, and reported upper limb pain, without any trade-off in safety outcomes. With further development of dedicated dual compression devices, the proposed technique should be freed from usage constraints. |
| first_indexed | 2024-03-09T17:43:46Z |
| format | Article |
| id | doaj.art-990047e07ab64e67a3f1548144aa4d4f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:46Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-990047e07ab64e67a3f1548144aa4d4f2023-11-24T11:21:27ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123701310.3390/jcm11237013Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-AnalysisFrancesco Condello0Michele Cacia1Matteo Sturla2Riccardo Terzi3Jorge Sánz-Sanchez4Bernhard Reimers5Gabriele L. Gasparini6Paolo Pagnotta7Sabato Sorrentino8Carmen Spaccarotella9Ciro Indolfi10Alberto Polimeni11Department of Biomedical Sciences, Humanitas University, 20090 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, 20090 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, 20090 Milan, ItalyIRCCS Ospedale Galeazzi-Sant’Ambrogio, University Cardiology Department, 20157 Milan, ItalyHospital Universitario y Politécnico La Fe, 46026 Valencia, SpainIRCCS Humanitas Research Hospital, 20089 Milan, ItalyIRCCS Humanitas Research Hospital, 20089 Milan, ItalyIRCCS Humanitas Research Hospital, 20089 Milan, ItalyCenter for Cardiovascular Research, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Advanced Biomedical Science, Federico II University, 80138 Naples, ItalyCenter for Cardiovascular Research, Magna Graecia University, 88100 Catanzaro, ItalyCenter for Cardiovascular Research, Magna Graecia University, 88100 Catanzaro, ItalyBackground: Simultaneous ulnar and radial artery compression (SURC) has emerged as a strategy to increase radial artery flow and mitigate radial artery occlusion (RAO) while achieving adequate hemostasis after transradial access (TRA), though its technical adoption has been limited worldwide. Methods: A systematic search of studies comparing SURC versus isolated radial artery compression after TRA for coronary angiography and/or intervention was performed. Data were pooled by meta-analysis using random-effects models. Odds ratios (OR) with relative 95% confidence intervals (CI) and standardized mean difference were used as measures of effect estimates. The primary endpoint was the occurrence of overall RAO. Results: A total of 6 studies and 6793 patients were included. SURC method as compared to isolated radial artery compression was associated with a lower risk of RAO both overall (OR 0.29; 95% CI, 0.13–0.61, <i>p</i> < 0.001; number needed to treat to benefit [NNTB] =38) and in-hospital (OR 0.28; 95% CI: 0.10 to 0.75; <i>p</i> = 0.01, NNTB = 36), with a reduced risk of unsuccessful patent hemostasis (OR: 0.13; 95% CI: 0.02 to 0.85; <i>p</i> = 0.03, NNT = 5) and upper extremity pain (OR: 0.48; 95% CI: 0.24 to 0.95; <i>p</i> = 0.04, NNTB = 124). No significant difference was observed in hemostasis time and in the risk of hematoma. Conclusion: Compared to isolated radial artery compression, SURC is associated with lower risk of RAO, unsuccessful patent hemostasis, and reported upper limb pain, without any trade-off in safety outcomes. With further development of dedicated dual compression devices, the proposed technique should be freed from usage constraints.https://www.mdpi.com/2077-0383/11/23/7013radial accessradial artery occlusionhemostasiscoronary angiographypercutaneous coronary intervention |
| spellingShingle | Francesco Condello Michele Cacia Matteo Sturla Riccardo Terzi Jorge Sánz-Sanchez Bernhard Reimers Gabriele L. Gasparini Paolo Pagnotta Sabato Sorrentino Carmen Spaccarotella Ciro Indolfi Alberto Polimeni Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis Journal of Clinical Medicine radial access radial artery occlusion hemostasis coronary angiography percutaneous coronary intervention |
| title | Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis |
| title_full | Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis |
| title_fullStr | Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis |
| title_short | Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis |
| title_sort | simultaneous radial and ipsilateral ulnar artery compression versus isolated radial artery compression after conventional radial access for coronary angiography and or intervention a systematic review and meta analysis |
| topic | radial access radial artery occlusion hemostasis coronary angiography percutaneous coronary intervention |
| url | https://www.mdpi.com/2077-0383/11/23/7013 |
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