TY - JOUR
T1 - Complications of transradial versus transfemoral access for neuroendovascular procedures
T2 - a meta-analysis
AU - Schartz, Derrek
AU - Akkipeddi, Sajal Medha K.
AU - Ellens, Nathaniel
AU - Rahmani, Redi
AU - Kohli, Gurkirat Singh
AU - Bruckel, Jeffrey
AU - Caplan, Justin M.
AU - Mattingly, Thomas K.
AU - Bhalla, Tarun
AU - Bender, Matthew T.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/8
Y1 - 2022/8
N2 - 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.
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.
UR - http://www.scopus.com/inward/record.url?scp=85126827923&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126827923&partnerID=8YFLogxK
U2 - 10.1136/neurintsurg-2021-018032
DO - 10.1136/neurintsurg-2021-018032
M3 - Article
C2 - 34479985
AN - SCOPUS:85126827923
SN - 1759-8478
VL - 14
SP - 820
EP - 825
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - 8
ER -