Universität zu Köln

Huang, Xinyue, Xiong, Yu, Guo, Xiumei, Kang, Xiaodong, Chen, Chunhui, Zheng, Hanlin, Pan, Zhigang, Wang, Lingxing, Zheng, Shuni, Stavrinou, Pantelis, Goldbrunner, Roland, Stavrinou, Lampis, Hu, Weipeng and Zheng, Feng (2022). Transradial versus transfemoral access for endovascular therapy of intracranial aneurysms: a systematic review and meta-analysis of cohort studies. Neurosurg. Rev., 45 (6). S. 3489 - 3499. NEW YORK: SPRINGER. ISSN 1437-2320

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Abstract

Endovascular treatment is widely used in the treatment of intracranial aneurysms. However, neurosurgeons are sceptical about endovascular access via the radial artery. We performed a systematic review and meta-analysis to compare the effectiveness and safety of transradial and transfemoral artery access in patients with intracranial aneurysms. We systematically searched the PubMed, Embase, and Cochrane databases for studies comparing the two approaches. The primary outcome was total complications, and the secondary outcomes were access site complications, intracranial haemorrhage, stroke, thromboembolism, silent infarct, re-treatment rate, mortality, complete occlusion of intracranial aneurysms, procedure duration, and length of hospital stay. A random-effects model was used to assess the pooled data. Of the 100 identified studies, 6 were eligible (a total of 3764 participants). There were no significant differences in total complications(odds ratio [OR] = 0.69, 95% confidence interval [CI] [0.33, 1.45], p = 0.32), complete occlusion of intracranial aneurysms (OR = 1.02, 95%CI [0.77,1.37], p = 0.87), procedure duration (mean difference [MD] = - 6.24, 95%CI [- 14.75, - 1.54], p = 0.95), or length of hospital stay (MD = 2.204, 95%CI [- 0.05, 4.45], p = 0.95), access site complications (OR = 0.49, 95%CI [0.16, 1.52], p = 0.22), intracranial haemorrhage (OR = 1.07, 95%CI [0.49, 2.34], p = 0.86), stroke (OR = 0.59, 95%CI [0.20, 1.77], p = 0.35), thromboembolism (OR = 0.85, 95%CI [0.33, 2.17], p = 0.74), silent infarct (OR = 0.69, 95%CI [0.04, 11.80], p = 0.80), retreatment rate (OR = 1.32, 95%CI [0.70, 2.48], p = 0.39), mortality (OR = 1.41, 95%CI [0.06, 5.20], p = 0.61), immediate occlusion (OR = 0.99, 95%CI [0.64, 1.51], p = 0.95), and occlusion during follow-up (OR = 1.10, 95%CI [0.56, 2.16], p = 0.74) between the transradial and transfemoral groups. This study showed comparable safety and efficacy outcomes between transradial and transfemoral access in patients with intracranial aneurysms treated endovascularly. Future large randomised trials are warranted to confirm these findings.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Huang, Xinyue UNSPECIFIED UNSPECIFIED UNSPECIFIED Xiong, Yu UNSPECIFIED UNSPECIFIED UNSPECIFIED Guo, Xiumei UNSPECIFIED UNSPECIFIED UNSPECIFIED Kang, Xiaodong UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, Chunhui UNSPECIFIED UNSPECIFIED UNSPECIFIED Zheng, Hanlin UNSPECIFIED UNSPECIFIED UNSPECIFIED Pan, Zhigang UNSPECIFIED UNSPECIFIED UNSPECIFIED Wang, Lingxing UNSPECIFIED UNSPECIFIED UNSPECIFIED Zheng, Shuni UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Pantelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Lampis UNSPECIFIED UNSPECIFIED UNSPECIFIED Hu, Weipeng UNSPECIFIED UNSPECIFIED UNSPECIFIED Zheng, Feng UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-678167
DOI:	10.1007/s10143-022-01868-3
Journal or Publication Title:	Neurosurg. Rev.
Volume:	45
Number:	6
Page Range:	S. 3489 - 3499
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1437-2320
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FLOW DIVERSION; MANAGEMENT Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67816