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Transcarotid versus transfemoral access for cerebrovascular intervention: protocol for a systematic review and
Jichang Luo1,2, Wanying Liao3, Dong Lei4
1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Insights
This systematic review compares transcarotid arterial access (TCA) with transfemoral arterial access (TFA) for cerebrovascular interventions. It aims to determine the safety and efficacy of these two crucial interventional access methods.
Area of Science:
- Neurology
- Interventional Cardiology
- Medical Technology
Background:
- Cerebrovascular intervention is vital for treating cerebrovascular diseases.
- Transfemoral arterial access (TFA) is common but has limitations.
- Transcarotid arterial access (TCA) offers an alternative for improved intervention.
Purpose of the Study:
- To systematically review and compare the safety and efficacy of TCA versus TFA in cerebrovascular interventions.
- To provide evidence-based insights into optimal interventional access strategies.
Main Methods:
- Systematic review following PRISMA protocols.
- Searches of PubMed, Embase, Web of Science, and Cochrane Library from January 2004.
- Inclusion of clinical trials (>30 participants) reporting stroke, death, and myocardial infarction endpoints.
Main Results:
- Data extraction and bias risk assessment by two independent investigators.
- Statistical analysis using standardized mean difference and risk ratios with 95% CIs.
- Subgroup, sensitivity, and publication bias analyses planned.
Conclusions:
- The review will synthesize evidence on TCA vs. TFA safety and efficacy.
- Findings will inform clinical decisions regarding cerebrovascular intervention access.
- Publication in a peer-reviewed journal is planned.
Introduction:
Cerebrovascular intervention is an excellent option to treat cerebrovascular diseases. Interventional access is a prerequisite and a foundation for cerebrovascular intervention, which is crucial to the success of an intervention. Although transfemoral arterial access (TFA) has become a popular and acceptable method of access for cerebrovascular angiography and intervention in clinical practice, it has some drawbacks that limit the usage in cerebrovascular interventions. Therefore, transcarotid arterial access (TCA) has been developed in cerebrovascular interventions. We aim to conduct a systematic review to compare the safety and efficacy of TCA with TFA for cerebrovascular intervention.
Methods And Analysis:
In this protocol, Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols were followed. PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials will be searched mainly from 1 January 2004, to the formal search date. Additionally, reference lists and clinical trial registries will be searched. We will include clinical trials with more than 30 participants, which reported the endpoints of stroke, death and myocardial infarction. Two investigators will independently select studies, extract data and assess bias risk. A standardised mean difference with 95% CI will be presented for continuous data, and a risk ratio with 95% CI will be presented for dichotomous data. On inclusion of sufficient studies, subgroup analysis and sensitivity analysis will be conducted. The funnel plot and Egger's test will be used to assess publication bias.
Ethics And Dissemination:
As only published sources will be used in this review, ethical approval is not required. We will publish the results in a peer-reviewed journal.
Prospero Registration Number:
CRD42022316468.
