No abstract

Historically, transfemoral approach (TFA) was the main access site for percutaneous coronary procedure. Over the past decade, transradial approach (TRA) has been gaining popularity over (TFA). With frequent use of TRA, we have recognized the advantage of TRA over TFA. Multiple trials have been conducted to investigate TRAs' benefits and risk. We have performed a literature search on TRA vs TFA, on the advantages and disadvantages of both approaches. A total of 140 citations were identified but only 38 filled our eligibility criteria.In this review, we found that TRA is associated with reduction of access site complication, time to ambulation and cardiac related death. However, lack of training and hesitancy of older interventionalist to switch approach is an impediment to the increased use of TRA. While the transfemoral approach has a higher access site complication rate, it is still integral as an access option.

Materials and Methods Relevant studies were identified by searching the following data sources-Medline via Ovid, Embase, Cochrane Library and using the 'related citation' search tool in PubMed. Reference lists from identified studies were also scanned to identify any other relevant studies. The following inclusion criteria were used: (i) studies comparing patients undergoing transfemoral or transradial approach (ii) comparison of outcome, benefit and risk between the two approaches. Meta analyses and systemic review were also included in this review. Duplicate publications were excluded. The search strategy identified 155 citations. 25 studies were duplicates and after screening of titles and abstracts, a further 83 studies were included. Of the 83 studies selected, 47 fulfilled out eligibility criteria and are included in this systematic review.