Meta-analysis of stroke after transradial versus transfemoral artery catheterization

Int J Cardiol. 2013 Oct 15;168(6):5234-8. doi: 10.1016/j.ijcard.2013.08.026. Epub 2013 Aug 14.

Abstract

Background: Transradial (TR) catheterization is gaining popularity due to its association with lower bleeding and access site complications, improved patient comfort, and lower costs compared to transfemoral (TF) catheterization; however, there is concern that TR catheterization may be associated with an increased risk of neurological complications. New randomized data has emerged since the publication of the last meta-analysis evaluating the risk of stroke between TR and TF catheterization in 2009.

Methods: We conducted a meta-analysis of randomized studies published until 2013 reporting risk of stroke in TR vs. TF catheterization.

Results: Data from 11,273 patients in 13 studies were collated. The majority of patients were men, and 8987 (79.7%) were enrolled in acute coronary syndrome trials. Very few patients had a history of prior coronary artery bypass grafting, and approximately 2/3 of patients underwent percutaneous coronary intervention. Stroke occurred in 25 of 5659 patients in the TR group, vs. 24 of 5614 patients in the TF group. There was no difference in stroke rates between the TR and TF groups (risk difference 0.00%, 95% confidence interval -0.29%-0.25%, p=0.88).

Conclusions: TR catheterization is not associated with a significant increase in stroke compared to TF catheterization.

Keywords: Catheterization; Stroke; Transradial.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Coronary Syndrome / epidemiology*
  • Acute Coronary Syndrome / therapy*
  • Angioplasty, Balloon, Coronary / statistics & numerical data
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / statistics & numerical data*
  • Coronary Artery Bypass / statistics & numerical data
  • Female
  • Femoral Artery
  • Humans
  • Male
  • Radial Artery
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology*