RT Journal Article
SR Electronic
T1 Complications of transradial versus transfemoral access for neuroendovascular procedures: a meta-analysis
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 820
OP 825
DO 10.1136/neurintsurg-2021-018032
VO 14
IS 8
A1 Derrek Schartz
A1 Sajal Medha K Akkipeddi
A1 Nathaniel Ellens
A1 Redi Rahmani
A1 Gurkirat Singh Kohli
A1 Jeffrey Bruckel
A1 Justin M Caplan
A1 Thomas K Mattingly
A1 Tarun Bhalla
A1 Matthew T Bender
YR 2022
UL http://jnis.bmj.com/content/14/8/820.abstract
AB Background Transradial access (TRA) has gained increased usage among neurointerventionalists. However, the overall safety profile of access site complications (ASCs) and non-access site complications (NASCs) of TRA versus transfemoral access (TFA) for neuroendovascular procedures remains unclear.Methods A systematic literature review and meta-analysis using a random effects model was conducted to investigate the pooled odds ratios (OR) of ASCs and NASCs. Randomized, case–control, and cohort studies comparing access-related complications were analyzed. An assessment of study heterogeneity and publication bias was also completed.Results Seventeen comparative studies met the inclusion criteria for final analysis. Overall, there was a composite ASC rate of 1.8% (49/2767) versus 3.2% (168/5222) for TRA and TFA, respectively (P<0.001). TRA was associated with a lower odds of ASC compared with TFA (OR 0.42; 95% CI 0.25 to 0.68, P<0.001, I2=31%). There was significantly lower odds of complications within the intervention and diagnostic subgroups. For NASC, TRA had a lower composite incidence of complications than TFA at 1.2% (31/2586) versus 4.2% (207/4909), P<0.001). However, on meta-analysis, we found no significant difference overall between TRA and TFA for NASCs (OR 0.79; 95% CI 0.51 to 1.22, P=0.28, I2=0%), which was also the case on subgroup analysis.Conclusion On meta-analysis, the current literature indicates that TRA is associated with a lower incidence of ASCs compared with TFA, but is not associated with a lower rate of NASCs.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.