Skip to main content
Journal cover image

Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis.

Publication ,  Journal Article
Nikolakopoulos, I; Vemmou, E; Xenogiannis, I; Karacsonyi, J; Rao, SV; Romagnoli, E; Tsigkas, G; Milkas, A; Velagapudi, P; Alaswad, K; Garcia, S ...
Published in: Catheter Cardiovasc Interv
February 2022

BACKGROUND: The optimal access site for cardiac catheterization in patients with prior coronary artery bypass surgery (CABG) continues to be debated. METHODS: We performed a random effects frequentist and Bayesian meta-analysis of 4 randomized trials and 18 observational studies, including 60,192 patients with prior CABG (27,236 in the radial group; 32,956 in the femoral group) that underwent cardiac catheterization. Outcomes included (1) access-site complications, (2) crossover to a different vascular access, (3) procedure time, and (4) contrast volume. Mean differences (MD) and 95% confidence interval (CI) were calculated for continuous outcomes and odds ratios (OR) and 95% CI for binary outcomes. RESULTS: Among randomized trials, crossover (OR: 7.63; 95% CI: 2.04, 28.51; p = 0.003) was higher in the radial group, while access site complications (OR: 0.96; 95% CI: 0.34, 2.87; p = 0.94) and contrast volume (MD: 15.08; 95% CI: -10.19, 40.35; p = 0.24) were similar. Among observational studies, crossover rates were higher (OR: 5.09; 95% CI: 2.43, 10.65; p < 0.001), while access site complication rates (OR: 0.52; 95% CI: 0.30, 0.89; p = 0.02) and contrast volume (MD: -7.52; 95% CI: -13.14, -1.90 ml; p = 0.009) were lower in the radial group. Bayesian analysis suggested that the odds of a difference existing between radial and femoral are small for all endpoints except crossover to another access site. CONCLUSION: In a frequentist and Bayesian meta-analysis of patients with prior CABG undergoing coronary catheterization, radial access was associated with lower incidence of vascular access complications and lower contrast volume but also higher crossover rate.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

February 2022

Volume

99

Issue

2

Start / End Page

462 / 471

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Humans
  • Femoral Artery
  • Coronary Artery Bypass
  • Catheterization, Peripheral
  • Cardiovascular System & Hematology
  • Bayes Theorem
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nikolakopoulos, I., Vemmou, E., Xenogiannis, I., Karacsonyi, J., Rao, S. V., Romagnoli, E., … Brilakis, E. S. (2022). Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis. Catheter Cardiovasc Interv, 99(2), 462–471. https://doi.org/10.1002/ccd.30010
Nikolakopoulos, Ilias, Evangelia Vemmou, Iosif Xenogiannis, Judit Karacsonyi, Sunil V. Rao, Enrico Romagnoli, Grigorios Tsigkas, et al. “Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis.Catheter Cardiovasc Interv 99, no. 2 (February 2022): 462–71. https://doi.org/10.1002/ccd.30010.
Nikolakopoulos I, Vemmou E, Xenogiannis I, Karacsonyi J, Rao SV, Romagnoli E, et al. Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis. Catheter Cardiovasc Interv. 2022 Feb;99(2):462–71.
Nikolakopoulos, Ilias, et al. “Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis.Catheter Cardiovasc Interv, vol. 99, no. 2, Feb. 2022, pp. 462–71. Pubmed, doi:10.1002/ccd.30010.
Nikolakopoulos I, Vemmou E, Xenogiannis I, Karacsonyi J, Rao SV, Romagnoli E, Tsigkas G, Milkas A, Velagapudi P, Alaswad K, Rangan BV, Garcia S, Burke MN, Brilakis ES. Radial versus femoral access in patients with coronary artery bypass surgery: Frequentist and Bayesian meta-analysis. Catheter Cardiovasc Interv. 2022 Feb;99(2):462–471.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

February 2022

Volume

99

Issue

2

Start / End Page

462 / 471

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Humans
  • Femoral Artery
  • Coronary Artery Bypass
  • Catheterization, Peripheral
  • Cardiovascular System & Hematology
  • Bayes Theorem