Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta-analysis

Introduction Coronary angiography and angioplasty via transradial approach is shown to be associated with significant reduction in access site complications. Due to a lack of sufficient data, the use of the right or left radial approach is still operator‐dependent. We performed a meta‐analysis of prospective randomized studies to compare right versus left radial artery approach for coronary procedures. Methods We found 12 randomized studies meeting the predetermined inclusion criteria. A total of 6,450 patients were included in the meta‐analysis of which 3,217 patients underwent coronary procedures via right radial approach and 3,233 patients via left radial approach. The primary endpoint was the comparison of fluoroscopy time, procedure time, contrast use and cross‐over rates between two radial approaches. Results Pooled analysis of the included studies showed a similar rate of cross‐over events (4.2% for right radial approach vs. 4.1% for left radial approach, odds ratio (OR)=1.08, P = 0.68), and similar total procedure times (18.8 ± 10.3 min vs. 18.1 ± 10.0 min, standard difference (SD) of the mean = 0.09, P = 0.162) between the two radial approaches. However, the right radial approach was found to be associated with minimally longer fluoroscopy times (5.8 ± 4.4 min vs. 5.3 ± 4.2 min, SD of the mean = 0.157, P