摘要
目的 通过系统评价和Meta分析评估经远端桡动脉路径(distal radial access,DRA)行脑血管造影的安全性和有效性.很多研究已经表明,经DRA行冠脉造影(coronary angiography,CAG)和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)是安全有效的.经DRA行脑血管造影的安全性和有效性尚不清楚.方法 检索PubMed、Embase、Cochrane、万方、中国知网、维普数据库建库以来至2023年5月1日有关经DRA行脑血管造影的文献,通过文献筛选、数据提取和文献质量评价,采用随机效应模型进行Meta分析.结果 检索到239项研究,最终纳入12项研究进行分析(共858例患者).路径成功率为0.96(95％CI:0.94～0.98),异质性明显(12=64.4％).路径相关并发症发生率为0.03(95％CI:0.01～0.05),异质性较低(I2=35.4％).部分研究的循证医学证据等级较低.结论 DRA完全可以作为脑血管造影的可选路径,经DRA行脑血管造影是安全有效的.
Abstract
Objective Through systematic evaluation and meta-analysis to assess the safety and effectiveness of cerebral angiography via distal radial access(DRA).Many studies have indicated that coronary angiography(CAG)and percutaneous coronary intervention(PCI)via DRA are clinically safe and effective.However,the safety and effectiveness of cerebral angiography via DRA are still not clear so far.Methods A computerized retrieval of academic papers concerning the safety and effectiveness of cerebral angiography via DRA from the databases of PubMed,Embase,Cochrane Library,Wanfang,CNKI,and VIP databases was conducted.The retrieval time period was from the establishment of the database to May 1,2023.After literature screening,data extraction,and literature quality assessment,meta-analysis was conducted by using a random effect model.Results A total of 239 studies were retrieved,and 12 studies(including 858 patients)were finally enrolled for this meta-analysis.The pooled access success rate was 0.96(95％CI=0.94-0.98),and the heterogeneity was obvious(I2=64.4％).The incidence of pooled access-related complications was 0.03(95％CI=0.01-0.05),and the heterogeneity was low(I2=35.4％).In some studies,the grade of evidence-based medical evidences was lower.Conclusion DRA can be reliably used as an alternative access for cerebral angiography,and it is clinically safe and effective to perform cerebral angiography via DRA.(J Intervent Radiol,2024,33:355-362)
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