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Stroke risk in radial versus femoral approach in coronary intervention: an updated systematic review and

Aditya M Desai1, Darshi Desai1, Arnold Gan1

  • 1Department of Internal Medicine, University of California, Riverside School of Medicine, Riverside.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|July 6, 2023
PubMed

Insights

Transradial (TR) and transfemoral (TF) approaches for cardiac catheterization (CC) have similar stroke risks. This systematic review and meta-analysis found no significant difference in stroke outcomes between TR and TF access in over a million patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Neurology

Background:

  • Peri-cardiac catheterization (CC) stroke poses significant risks, yet comparative stroke risk between transradial (TR) and transfemoral (TF) approaches remains unclear.
  • Understanding these risks is crucial for optimizing patient safety and procedural choices in CC.

Approach:

  • A systematic review and meta-analysis was conducted, searching MEDLINE, EMBASE, and PubMed from 1980 to June 2022.
  • Included were randomized trials and observational studies comparing radial versus femoral access for CC or intervention, focusing on reported stroke events.
  • A random-effects model was employed for data analysis.

Key Points:

  • Analysis of 41 pooled studies (1,112,136 patients) and 18 randomized-controlled trials (45,844 patients) revealed no statistically significant difference in stroke outcomes between TR and TF approaches.
  • Odds ratio for stroke between TR and TF was 0.71 (95% CI 0.48-1.06).
  • Meta-regression analysis also showed no significance in stroke outcomes related to procedural duration between the two access sites.

Conclusions:

  • The study concludes that there is no significant difference in stroke outcomes when comparing the transradial approach versus the transfemoral approach for cardiac catheterization.
  • These findings suggest that procedural choice between TR and TF access may not significantly impact stroke risk.
Abstract

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