Distal Radial Artery Access for Noncoronary Peripheral Endovascular Treatment: A Systematic Review and Meta-Analysis

The distal radial access (DRA) is frequently used in coronary procedures, exhibiting lower complication and morbidity rates than conventional femoral access. In this study, we aimed to evaluate the use of DRA in minimally invasive peripheral noncoronary procedures.

MEDLINE, EMBASE, and Cochrane databases were systematically accessed in search of studies that used DRA and reported the rate of technically successful procedures and complications related to the access. "Software R" was employed for statistical analysis. Heterogeneity was assessed using the I² statistical model. The "Risk of Bias in Nonrandomized Studies of Interventions" tool assessed the selected studies' bias risk. The study was registered on the Prospective Register of Systematic Reviews platform under the number CRD42024604819.

Fourteen studies were included, totaling 1664 patients. The most common procedures performed were transcatheter arterial chemoembolization of the liver (69.1%), visceral artery embolisms (13.7%), yttrium-90 mapping (13.5%), and yttrium-90 administration (12.7%). Technical success was achieved in 97.4% of procedures (95% confidence interval (CI): 94.80-99.17; I² = 89%; P < 0.01). In the subanalysis of liver interventions, success was 96.6% (95% CI: 92.17-99.51; I² = 92%; P < 0.01). The prevalence of adverse events was 2.3% (95% CI: 0.7-4.59; I² = 89%; P < 0.01). Only 1.1% of liver procedures presented complications (95% CI: 0.02-3.79; I² = 90%; P < 0.01). No serious adverse effects were reported. Bias analysis showed a high risk in most included articles.

DRA can be a safe and effective modality for peripheral minimally invasive procedures.