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We read with interest the manuscript entitled ‘Radial first or patient first: a case series and meta-analysis of transradial (TRA) versus transfemoral (TFA) access for acute ischemic stroke intervention’ by Siddiqui et al.1 We respect the authors on this important undertaking, but we would like to point out the following concerns in order to advance this new technique.
‘Patient first’ should not lead to a general statement of ‘radial or femoral first approach’ in acute ischemic stroke intervention. Acute ischemic stroke intervention comprises a variety of different procedures with different technical demands. In their manuscript, there was lack of data on patient-specific anatomic features and other variables to allow identification of subgroups that might benefit from a particular access route. For instance, there was a paucity of posterior circulation strokes in the meta-analysis, with 88.9% being anterior circulation. We have previously shown significantly shorter skin puncture to reperfusion times in …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.