Table 2

Recent comparative studies of transradial versus transradial access for neuroendovascular procedures

RefStudy populationN
(radial arm)
Study designAccess site complication rate
(radial vs femoral)
Overall complication rate
(radial vs femoral)
Crossover rate
(radial vs femoral)
Follow-up intervalWeaknesses
82 Interventional (thrombectomy, thrombolysis, carotid) and diagnostic206
(20%)
  • Retrospective cohort

  • Single center

3
(1.5% vs 6%)
4
(2.0% vs 7.0%)
3
(1.5% vs 1.3%)
UnclearNon-randomized study
(patient selection bias)
Possible misclassification bias (no uniform follow-up protocol)
83 Flow diversion134
(6%)
  • Retrospective cohort

  • Multicenter

0
(0% vs 2.48%)
5
(3.73% vs 9.02%)
12
(8.63%)
UnclearNon-randomized study
(patient selection bias)
Possible misclassification bias (no uniform follow-up protocol)
84 Anterior circulation mechanical thrombectomy130
(35%)
  • Retrospective cohort

  • Single center

0
(0% vs 6.5%)
3
(2.3% vs 11.4%)
6
(4.6% vs 1.6%)
90 daysNon-randomized study
(patient selection bias)
Possible misclassification bias (no US as part of follow-up)
4 Cerebral arteriography with right TRA158
(51%)
  • Prospective cohort

  • Single-center

4
(2.5% vs 5.8%)
4
(2.5% vs 5.8%)
5
(3.2% vs 1.3%)
UnclearNon-randomized study
(patient selection bias)
Possible misclassification bias (no uniform follow-up protocol)
85 Diagnostic angiograms performed by two new fellows169 (58%)
  • Prospective cohort

  • Single center

2
(1.2% vs 1.6%)
2
(1.2% vs 1.6%)
6
(2.1% vs not reported)
UnclearNon-randomized study
(patient selection bias)
Possible misclassification bias (no uniform follow-up protocol)
86 Neurointerventional treatments (embolization, thrombectomy)162
(28%)
  • Retrospective cohort

  • Single center

2
(1.2% vs 6.7%)
5
(3% vs 10%)
7
(4% vs 3.1%)
UnclearNon-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 label49
(1.4% vs 3.7%)
167
(4.8% vs 7.4%)
265
(7.6% vs 2.0%)
30 daysFollow-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 yearFollow-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.