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Meta-Analysis
. 2018 Oct;25(5):599-607.
doi: 10.1177/1526602818792854. Epub 2018 Aug 8.

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

Max M Meertens  1   2   3 , Eugene Ng  1   4 , Stanley E K Loh  1   5 , Miny Samuel  1   6 , Barend M E Mees  2   3 , Andrew M T L Choong  1   7   8
Affiliations
Meta-Analysis

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

Max M Meertens et al. J Endovasc Ther. 2018 Oct.

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.

Keywords: access route; angioplasty; aortoiliac interventions; common femoral artery; common iliac artery; external iliac artery; femoropopliteal segment; occlusion; peripheral artery disease; popliteal artery; radial artery; stenosis; stent; superficial femoral artery.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of the systematic review.
Figure 2.
Figure 2.
Forest plots of the (A) procedure success and (B) complications outcomes. CI, confidence interval, M-H, Mantel-Haenszel.
See this image and copyright information in PMC

Comment in

  • Commentary: The Long and Winding Road.
    Lorenzoni R, Roffi M. Lorenzoni R, et al. J Endovasc Ther. 2018 Oct;25(5):608-610. doi: 10.1177/1526602818795873. Epub 2018 Aug 29. J Endovasc Ther. 2018. PMID: 30153773 No abstract available.

References

    1. Campeau L. Percutaneous radial artery approach for coronary angiography. Catheter Cardiovasc Diagn. 1989;16:3–7. - PubMed
    1. Rao S, Stone G. Arterial access and arteriotomy site closure devices. Nat Rev Cardiol. 2016;13:641–650. - PubMed
    1. Gan L, Lib Q, Liuc R. Effectiveness and feasibility of transradial approaches for primary percutaneous coronary intervention in patients with acute myocardial infarction. J Nanjing Med Univ. 2009;23:270–274.
    1. Posham R, Biederman DM, Patel RA. Transradial approach for noncoronary interventions: a single-center review of safety and feasibility in the first 1,500 cases. J Vasc Interv Radiol. 2016;27:159–166. - PubMed
    1. Sixt S, Alawied A, Rastan A. Acute and long-term outcome of endovascular therapy for aortoiliac occlusive lesions stratified according to the TASC classification: a single-center experience. J Endovasc Ther. 2008;15:408–416. - PubMed