Transradial Approach for Aortoiliac and Femoropopliteal Interventions: A Systematic Review and Meta-analysis

Author:

Meertens Max M.123ORCID,Ng Eugene14,Loh Stanley E. K.15,Samuel Miny16,Mees Barend M. E.23,Choong Andrew M. T. L.178

Affiliation:

1. SingVaSC, Singapore Vascular Surgical Collaborative, Singapore

2. Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, the Netherlands

3. European Vascular Center Aachen-Maastricht, Aachen, Germany

4. Department of Vascular Surgery, Westmead Hospital, Westmead, NSW, Australia

5. Department of Diagnostic Imaging, National University Hospital, Singapore

6. Systematic Review Unit, Yong Loo Lin School of Medicine, National University of Singapore

7. Division of Vascular Surgery, National University Heart Centre, Singapore

8. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore

Abstract

Purpose: To present a systematic review and meta-analysis comparing the transradial approach for aortoiliac and femoropopliteal interventions to the traditional transfemoral access. Methods: A search of the public domain databases MEDLINE, SCOPUS, Web of Science, and Cochrane Library Databases was performed to identify studies related to the use of the transradial approach for infra-aortic procedures. Meta-analysis was used to compare the transradial to the transfemoral route in terms of procedure success, complications, procedure parameters, and hospital length of stay. Results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: Nineteen studies containing 638 patients with transradial access for lower limb interventions were selected. Lesions were treated from the aortic bifurcation down to the popliteal artery. The mean technical success rate was 90.9%, conversion to a transfemoral approach was necessary in 9.9%, and complications were reported in 1.9%. The meta-analysis included 4 comparative studies involving 114 transradial and 208 transfemoral procedures. There was no significant advantage of either approach in terms of procedure success (OR 5.0, 95% CI 0.49 to 50.83, p=0.17), but the risk of developing a complication was significantly lower (OR 0.25, 95% CI 0.07 to 0.86, p=0.03) with the transradial approach. Conclusion: Transradial access for lower limb endovascular interventions can be performed with comparable technical success and a lower overall complication profile compared to transfemoral access.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging,Surgery

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