Transradial Approach for Aortoiliac and Femoropopliteal Interventions: A Systematic Review and Meta-analysis

Max M. Meertens*, Eugene Ng, Stanley E. K. Loh, Miny Samuel, Barend M. E. Mees, Andrew M. T. L. Choong

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

17 Citations (Web of Science)

Abstract

Purpose: To present a systematic review and meta-analysis comparing the transradial approach for aortoiliac and femoropopliteal interventions to the traditional transfemoral access. Methods: A search of the public domain databases MEDLINE, SCOPUS, Web of Science, and Cochrane Library Databases was performed to identify studies related to the use of the transradial approach for infra-aortic procedures. Meta-analysis was used to compare the transradial to the transfemoral route in terms of procedure success, complications, procedure parameters, and hospital length of stay. Results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: Nineteen studies containing 638 patients with transradial access for lower limb interventions were selected. Lesions were treated from the aortic bifurcation down to the popliteal artery. The mean technical success rate was 90.9%, conversion to a transfemoral approach was necessary in 9.9%, and complications were reported in 1.9%. The meta-analysis included 4 comparative studies involving 114 transradial and 208 transfemoral procedures. There was no significant advantage of either approach in terms of procedure success (OR 5.0, 95% CI 0.49 to 50.83, p=0.17), but the risk of developing a complication was significantly lower (OR 0.25, 95% CI 0.07 to 0.86, p=0.03) with the transradial approach. Conclusion: Transradial access for lower limb endovascular interventions can be performed with comparable technical success and a lower overall complication profile compared to transfemoral access.
Original languageEnglish
Pages (from-to)599-607
Number of pages9
JournalJournal of Endovascular Therapy
Volume25
Issue number5
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • access route
  • angioplasty
  • aortoiliac interventions
  • common femoral artery
  • common iliac artery
  • external iliac artery
  • femoropopliteal segment
  • occlusion
  • peripheral artery disease
  • popliteal artery
  • radial artery
  • stenosis
  • stent
  • superficial femoral artery
  • FEMORAL-ARTERY
  • ILIAC ARTERY
  • CORONARY-ANGIOGRAPHY
  • ENDOVASCULAR THERAPY
  • KNEE ANGIOPLASTY
  • RADIAL ACCESS
  • FEASIBILITY
  • SAFETY

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