Transradial access for cerebral angiography and neurointerventional procedures: A meta-analysis and systematic review

Interv Neuroradiol. 2024 Jun;30(3):404-411. doi: 10.1177/15910199221112200. Epub 2022 Jul 15.

Abstract

Purpose: Transradial access (TRA) for diagnostic and interventional neurointerventional procedures has recently gained traction over transfemoral access (TFA) in the neurointerventional community. This meta-analysis aims to assess and summarize the utility of TRA in cerebral angiography and neurointerventional procedures.

Methods: A systematic literature review was performed utilizing Pubmed, Embase, and Scopus databases. Using PRISMA guidelines, records were extracted with the following search terms: transradial approach, transradial access, radial access, cerebral angiogram, cerebral angiography, neurointervention, and neuroendovascular. The primary outcomes assessed were case success rate, complication rate, and crossover rate from TRA to TFA. Secondary analysis was performed on procedure time, fluoroscopy time, fluoroscopy time per vessel (diagnostic procedures only), contrast dose, radial artery diameter, distal radial artery diameter, and patient preference for TRA over TFA.

Results: Sixty-two full-text articles were analyzed for this meta-analysis, representing 12,927 diagnostic and interventional TRA access patients. Our analysis revealed a combined diagnostic and interventional case success rate of 95.9% and complication rate of 3.5%, with crossover to TFA occurring in 4.9% of cases.

Conclusion: This meta-analysis demonstrates that TRA access for diagnostic angiography and neurointerventional procedures is a safe and effective approach, though determining a true complication rate is challenging as the definition of TRA complications has changed in various publications over time.

Keywords: cerebral angiography; neurointervention; radial artery; transradial access.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Cerebral Angiography*
  • Endovascular Procedures* / methods
  • Humans
  • Radial Artery* / diagnostic imaging
  • Radiography, Interventional / methods