Radial vs femoral access for the prevention of acute kidney injury (AKI) after coronary angiography or intervention: A systematic review and meta-analysis.

Andò, Giuseppe; Gragnano, Felice; Calabrò, Paolo; Valgimigli, Marco (2018). Radial vs femoral access for the prevention of acute kidney injury (AKI) after coronary angiography or intervention: A systematic review and meta-analysis. Catheterization and cardiovascular interventions, 92(7), E518-E526. Wiley-Blackwell 10.1002/ccd.27903

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OBJECTIVES We sought to investigate the impact of radial vs femoral access on the incidence of acute kidney injury (AKI) after coronary angiography or intervention. BACKGROUND There is a growing recognition of the importance of access site selection as an adjudicative measure to mitigate the risk of renal impairment for patients with coronary artery disease undergoing angiography with or without percutaneous coronary intervention. METHODS We conducted a systematic review of the literature and meta-analyzed available evidence comparing the rates of AKI with radial vs femoral access in patients undergoing coronary angiography or intervention. Studies reporting the incidence of AKI as a primary or secondary outcome were pooled in fixed- and random-effects meta-analyses and meta-regression techniques were used to account for across-study heterogeneity. RESULTS Across data pooled from nine studies (n = 32 181), radial access was significantly associated with a reduction in the incidence of AKI (OR 0.57, 95% CI 0.50 to 0.66, P < 0.0001 with fixed-effects model, OR 0.55, 95% CI 0.45 to 0.67, P < 0.0001 with random-effects model) as compared to femoral. In the meta-regression model, the effect size of radial access effect was related to the number of centers in which studies were conducted. CONCLUSIONS Compared with the femoral approach, radial access was associated with a lower incidence of AKI after coronary angiography or intervention, although this benefit was less pronounced in multicenter than in single-center studies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Valgimigli, Marco

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Amanda Valle

Date Deposited:

07 Mar 2019 15:06

Last Modified:

07 Mar 2019 15:06

Publisher DOI:

10.1002/ccd.27903

PubMed ID:

30244540

Uncontrolled Keywords:

acute angiography brachial/radial/ulnar catheterization coronary coronary artery disease percutaneous coronary intervention (PCI) renal disease

BORIS DOI:

10.7892/boris.124054

URI:

https://boris.unibe.ch/id/eprint/124054

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