Table 2

Random effects meta-analysis of the primary and secondary outcomes, heterogeneity testing, and bias risk assessment

Outcome
study
PatientsProcedural successCrossoverRadial/SCA* failureCCA cannulation failure†ARAOFAHAccess site major complicationsMinor CVA (d≤30)Major CVA (d≤30)Deaths
Gao et al, 201815 2828
(100.0%)
0
(0%)
000
(0%)
0
(0%)
0
(0%)
0
(0%)
0
(0%)
0
(0%)
Mendiz et al, 201614 10196
(95.0%)
5
(5.0%)
0/55/5
R 4
L 1: 1 NB
NR1
(1.0%)
0
(0%)
1
(1.0%)
2
(2.0%)
0
(0%)
Ruzsa et al, 20142 130117
(90.0%)
13
(10.0%)
7/136/13
R 2
L 4: 4 NB
8
(6.2%)
2
(1.5%)
2
(1.5%)
0
(0%)
1
(0.8%)
2
(1.5%)
Etxegoien et al, 201211 382347
(90.8%)
35
(9.2%)
0/3535/35
R 15
L 20: 18 NB
23
(6.0%)
NR0
(0%)
13
(3.4%)
2
(0.5%)
1
(0.3%)
Patel et al, 201012 2016
(80.0%)
4
(20.0%)
0/44/4
R 0
L 4: NR
NR0
(0%)
0
(0%)
1
(5.0%)
0
(0%)
0
(0%)
Pinter et al, 200713 2018
(90.0%)
2
(10.0%)
1/21/2
R 0
L 1: 1 NB
1
(5.0%)
0
(0%)
0
(0%)
0
(0%)
0
(0%)
0
(0%)
Folmar et al, 200710 4235
(83.3%)
7
(16.7%)
0/77/7
R 1
L 6: 5 NB
NR0
(0%)
0
(0%)
1
(2.4%)
0
(0%)
0
(0%)
Total 723 657 66 8/66 58/66
R 22 L 36
NB 29/32
32/5603/34121653
Meta-analysis: Random effects (DerSimonian and Laird)
Proportion
(95% CI)
90.8%
(86.7% to
94.2%)
9.2%
(5.8% to 13.3%)
5.9%
(4.1% to
8.0%)
1.4%
(0.4% to 2.9%)
0.4%
(0.1% to
0.9%)
1.9%
(0.6% to
3.8%)
1.0%
(0.4% to 1.8%)
0.6%
(0.2% to 1.3%)
Heterogeneity testing
Cochran Q
(p value)
12.799
(0.046)
12.799
(0.046)
2.783
(0.426)
0.580
(0.989)
5.609
(0.468)
10.39
(0.109)
1.990
(0.921)
2.800
(0.834)
I2 53.1%53.1%0%0%0%42.3%0%0%
Statistically significantYesYesNoNoNoNoNoNo
Bias risk assessment
Egger
(p value)
−0.575
(0.639)
0.575
(0.639)
−0.996
(0.478)
−0.560
(0.071)
0.192
(0.439)
0.390
(0.652)
0.024
(0.954)
0.058
(0.851)
Harbord
(p value)
−0.435
(0.709)
0.435
(0.709)
−0.917
(0.300)
−1.046
(0.013)
0.046
(0.962)
−0.877
(0.363)
−0.225
(0.686)
−0.218
(0.740)
Statistically significantNoNoNoNoNoNoNoNo
  • ARAO, asymptomatic radial artery occlusion; CCA, common carotid artery; CVA, cerebrovascular accident; d≤30, occurring within 30 days after the procedure; FAH, forearm hematoma; L, left; NB, non-bovine; R, right; SCA, subclavian artery.

  • *Radial/SCA failure: procedural failure due to failed radial artery access, radial artery spasm, radial artery loop, or subclavian artery stenosis. 

  • †CCA cannulation failure: procedural failure due to inability to cannulate the affected common carotid artery with the guide catheter/sheath.