Abstract
Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis
Stroke: vascular and interventional neurology, Vol.3(S2), e12823_220
11/01/2023
DOI: 10.1161/SVIN.03.suppl_2.220
Abstract
Introduction Carotid artery stenting (CAS) has emerged as a viable alternative to carotid endarterectomy for managing carotid artery stenosis in high‐risk patients (1). While the transfemoral arterial approach (TF) remains the preferred method, it is associated with inherent limitations and potential complications (2‐4). Consequently, exploring the transradial artery access (TR) as a potential option becomes crucial in optimizing patient outcomes and procedural success rates. Limited data exists comparing the outcomes of TR approach in CAS to TF approach. This study aims to systematically review and meta‐analyze the outcomes and complication rates between TR and TF access for CAS. Methods A systematic electronic search was conducted in four databases up to May 10th, 2023. Studies with randomized or non‐randomized designs, involving CAS through TR or TF approach, were included. Outcomes of interest were stroke, transient ischemic attack (TIA), death, myocardial infarction (MI), and access site complications. A meta‐analysis was performed, analyzing pooled odds ratios (ORs) and 95% confidence intervals (CI) to assess the effect size of the vascular access approaches. Results Six studies with a total of 6,917 patients were included, out of which 602 (8.7%) underwent the TR approach, and 6,315 (91.3%) underwent the TF approach. Meta‐analysis results showed no significant difference in stroke occurrence between TR and TF groups (TR: 1.7% vs. TF: 1.9%; OR = 0.98; 95% CI 0.49 – 1.96; I2 = 0%). Similarly, no significant difference was found in death (TR: 1% vs. TF: 0.9%; OR = 0.95; 95% CI 0.38 – 2.37; I2 = 0%), MI (TR: 0.2% vs. TF: 0.3%; OR = 1.53; 95% CI 0.20 – 11.61; I2 = 0%), TIA (TR: 0.4% vs. TF: 1%; OR = 0.46; 95% CI 0.11 – 1.95; I2 = 0%), and access site complications (TR: 2.2% vs. TF: 1%; OR = 0.97; 95% CI 0.48 – 1.98; I2 = 0%). Conclusion In the comparison of TR and TF approaches for CAS, no significant differences were observed in stroke, death, MI, TIA, or access site complications. TR approach shows promise as an alternative method for CAS, offering potential benefits without increased risk of complications. However, further studies are needed to confirm these findings and establish guidelines for optimal access site selection.
Details
- Title: Subtitle
- Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis
- Creators
- Aaron Rodriguez-Calienes - University of IowaFabian A. Chavez-Ecos - Sociedad Científica de Estudiantes de Medicina de Ica Universidad Nacional San Luis Gonzaga Ica PeruDavid Espinosa-Martinez - Sociedad Científica de Estudiantes de Medicina de Ica Universidad Nacional San Luis Gonzaga Trujillo PeruDiego Bustamante-Paytan - Universidad de San Martín de PorresFernanda Nagheli Borjas-Calderón - Universidad de San Martín de PorresMilagros Galecio-Castillo - University of IowaJuan R. Vivanco-Suarez - Department of Neurology University of Iowa Hospitals and Clinics Iowa United StatesR Waldo Guerrero - Department of Neurology and Brain Repair University of South Florida Florida United StatesSantiago Ortega-Gutierrez - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Stroke: vascular and interventional neurology, Vol.3(S2), e12823_220
- DOI
- 10.1161/SVIN.03.suppl_2.220
- eISSN
- 2694-5746
- Publisher
- Wiley
- Language
- English
- Date published
- 11/01/2023
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984511954202771
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