A comparative study of transradial versus transfemoral approach for flow diversion

Weinberg, Joshua; Sweid, Ahmad; Hammoud, Batoul; Asada, Ashlee; Greco-Hiranaka, Cannon; Piper, Keenan; Gooch, M. Reid; Tjoumakaris, Stavropoula; Herial, Nabeel; Hasan, David; Zarzour, Hekmat; Rosenwasser, Robert H.; Jabbour, Pascal

doi:10.1007/s00234-021-02672-4

Cited by 11 publications

(9 citation statements)

References 40 publications

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“…After duplicate removal and abstract screening, 13 studies remained for full-text screening. After reading the full text, we included 8 studies (11)(12)(13)(14)(15)(16)(17)(18) in the meta-analysis. The 8 studies involved 265 FD-treated aneurysms via TRA in 250 patients.…”

Section: Search Resultsmentioning

confidence: 99%

“…At the same time, the TRA will not lead to the patient's bed for a long time, and will also reduce the incidence of lower extremity deep venous thrombosis (15,33,34). Secondly, several studies had shown that neurointerventional via TRA can reduce the discomfort of patients after interventional surgery, and reduce the cost of surgery, and length of hospital stay compared to TFA (3,11,(35)(36)(37). Especially for patients taking anticoagulants, pregnant women, patients with severe iliac atherosclerosis, bovine arch, type II/III aortic arch, the TRA should be the main access for FD in the treatment of intracranial aneurysms (11,38,39).…”

Section: Discussionmentioning

confidence: 99%

“…Other previous studies had also reported that FD in the treatment of intracranial aneurysms via TRA was mainly suitable for type III aortic arch or bovine arch configurations ( 24 , 25 ). At present, it has been the preferred access in some institutions with rich experience in the treatment of intracranial aneurysms with FD via TRA ( 11 , 13 , 15 ). When the radial artery is less than 2.0–2.5 mm on ultrasound, some studies suggest that TFA should be chosen.…”

Section: Discussionmentioning

confidence: 99%

“…The average age of the 8 studies included was 55-62.1 years. Six studies (11)(12)(13)(16)(17)(18) reported the laterality of aneurysms, 57.1% (92/161) of which were located on the left side and 7 studies (11)(12)(13)(14)(15)(16)(17) reported that 91.5% (238/260) of aneurysms were located in the anterior circulation. The 8 studies described in detail the use of drugs and operative procedures before operation.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

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Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

et al. 2022

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BackgroundWhile studies have confirmed that flow diversion (FD) can treat intracranial aneurysms via transradial approach (TRA), it remains unclear whether their treatment ultimately impacts safety and feasibility. We aim to conduct a systematic review and meta-analysis assessing the safety and feasibility after FD treatment of intracranial aneurysms via TRA.MethodsPubMed, EMBASE, and Web of Science were systematically reviewed. The primary outcomes were the success rate and the access-related complications of deploying FD via TRA. Meta-analysis was performed using a random or fixed effect model based on heterogeneity. And the publication bias was evaluated using a funnel plot. This study was registered with PROSPERO, number CRD42021244448.ResultsData from 8 studies met inclusion criteria (250 non-duplicated patients). The success rate was 93% (95% confidence interval [CI] 0.86–0.98; I2 = 61.05%; p = 0.01). The access-related complications rate was 1% (95% CI 0–0.03; I2 = 0.00%; p < 0.01). The mainly access-related complications included radial artery spasm (85.7%) and radial artery occlusion (14.3%). The TRA convert to transfemoral approach (TFA) was 7% (95% CI 0.02–0.14; I2 = 61.05%; p = 0.01).ConclusionsAlthough TFA is still the main access for FD in the treatment of intracranial aneurysms, the TRA also has a higher success rate and lower access-related complications rate. With the improvement of future experience and equipment, the TRA may become the main access for FD which has more advantages. Future studies should design prospective, multicenter randomized controlled studies for long-term follow-up.

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Characteristicsmentioning

confidence: 99%

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Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

et al. 2022

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“…Various studies have demonstrated its superiority over TFA in terms of fewer complications, faster recovery, and reduced hospitalization times. 18,19 Although the complication rate with TRA is low, the most commonly observed access site complications are vasospasm and radial artery occlusion. The incidence of vasospasm after trans-radial access is variable between 4 and 20%.…”

Section: Discussionmentioning

confidence: 99%

Common ground, different path: Ulnar artery access for interventional neurovascular procedures

et al. 2021

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Background Recently, radial artery access has gained popularity for interventional neurovascular procedures due to patient comfort and fewer complications. However, there are instances where the radial artery approach is not feasible. In such cases, trans-ulnar artery access (TUA) can offer an alternate route. There is limited data regarding neuro-interventional procedures performed via this approach. This study aims to evaluate the feasibility and safety of trans-ulnar approach for a wide range of interventional neurovascular procedures. Materials and methods The data for all patients who underwent ulnar artery access for diagnostic or interventional neuroradiology procedures was retrospectively collected between September 2020 and March 2021. Patient demographics, procedural details, procedure success, and complications were recorded. Results During the study period, 23 patients underwent 24 trans-ulnar approach procedures. The mean age of patients was 50.1 ± 14.2 years. Fourteen diagnostic cerebral angiograms and ten interventional procedures were performed. All procedures were successfully completed via trans-ulnar approach without a switch to alternate access. No major access site complication was observed. Conclusion Ulnar artery access is a safe and feasible option for neurovascular procedures. It can be effectively utilized for diagnostic cerebral angiography and a wide range of interventional procedures.

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Transradial versus transfemoral access for endovascular therapy of intracranial aneurysms: a systematic review and meta-analysis of cohort studies

et al. 2022

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A comparative study of transradial versus transfemoral approach for flow diversion

Cited by 11 publications

References 40 publications

Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

Common ground, different path: Ulnar artery access for interventional neurovascular procedures

Transradial versus transfemoral access for endovascular therapy of intracranial aneurysms: a systematic review and meta-analysis of cohort studies

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