Recent comparative studies of transradial versus transradial access for neuroendovascular procedures
| Ref | Study population | N (radial arm) | Study design | Access site complication rate (radial vs femoral) | Overall complication rate (radial vs femoral) | Crossover rate (radial vs femoral) | Follow-up interval | Weaknesses |
| 82 | Interventional (thrombectomy, thrombolysis, carotid) and diagnostic | 206 (20%) |
| 3 (1.5% vs 6%) | 4 (2.0% vs 7.0%) | 3 (1.5% vs 1.3%) | Unclear | Non-randomized study (patient selection bias) Possible misclassification bias (no uniform follow-up protocol) |
| 83 | Flow diversion | 134 (6%) |
| 0 (0% vs 2.48%) | 5 (3.73% vs 9.02%) | 12 (8.63%) | Unclear | Non-randomized study (patient selection bias) Possible misclassification bias (no uniform follow-up protocol) |
| 84 | Anterior circulation mechanical thrombectomy | 130 (35%) |
| 0 (0% vs 6.5%) | 3 (2.3% vs 11.4%) | 6 (4.6% vs 1.6%) | 90 days | Non-randomized study (patient selection bias) Possible misclassification bias (no US as part of follow-up) |
| 4 | Cerebral arteriography with right TRA | 158 (51%) |
| 4 (2.5% vs 5.8%) | 4 (2.5% vs 5.8%) | 5 (3.2% vs 1.3%) | Unclear | Non-randomized study (patient selection bias) Possible misclassification bias (no uniform follow-up protocol) |
| 85 | Diagnostic angiograms performed by two new fellows | 169 (58%) |
| 2 (1.2% vs 1.6%) | 2 (1.2% vs 1.6%) | 6 (2.1% vs not reported) | Unclear | Non-randomized study (patient selection bias) Possible misclassification bias (no uniform follow-up protocol) |
| 86 | Neurointerventional treatments (embolization, thrombectomy) | 162 (28%) |
| 2 (1.2% vs 6.7%) | 5 (3% vs 10%) | 7 (4% vs 3.1%) | Unclear | Non-randomized study (patient selection bias) Possible misclassification bias (no uniform follow-up protocol) |
| Large interventional cardiology RCTs for comparison: | ||||||||
| 42 | ACS (RIVAL) | 3507 (50%) | Multicenter, 32 countries, 1:1 randomization, open label | 49 (1.4% vs 3.7%) | 167 (4.8% vs 7.4%) | 265 (7.6% vs 2.0%) | 30 days | Follow-up lacks US assessment |
| 87 | ACS (MATRIX) | 4917 (50%) | European multicenter, 1:1 randomization, open label | 73 (1.8% vs 5.2%) | 460 (11% vs 13.6%) | 243 (5.8% vs 2.3%) | 30 days and 1 year | Follow-up lacks US assessment |
ACS, acute coronary syndrome; MATRIX, Minimizing Adverse haemorrhagic events by TRansradial access site and systemic Implementation of angioX; RCTs, randomized controlled trials; RIVAL, RadIal Vs femorAL access for coronary intervention; TRA, transradial access; US, ultrasound.