1. Transradial artery access for carotid artery stenting: A pooled analysis.
- Author
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Batista, Sávio, Oliveira, Leonardo de Barros, Sousa, Marcelo Porto, Pinheiro, Agostinho C, Borges, Jordana, Santana, Laís, Bertani, Raphael, Andreão, Filipi Fim, Simões, Adria, and Almeida Filho, José Alberto
- Abstract
Introduction: Carotid artery stenting (CAS) through transradial access (TRA) is emerging as an alternative to carotid endarterectomy. However, the current evidence base is limited, mainly comprising single-center studies. Objective: This systematic review and meta-analysis aim to assess the safety and effectiveness of TRA for CAS, providing evidence to support clinical decisions. Methods: We conducted searches on PUBMED, Cochrane Library, Embase, and Web of Science databases, including studies on TRA for CAS. Studies with fewer than 20 patients, non-primary outcomes, and non-full-text articles were excluded. Results: We analyzed 14 studies involving 1,166 patients who underwent CAS via TRA. Procedural success rate was high in 13 studies, with a 95% rate (95% CI; 92%–98%). Crossover to TFA access was observed in 12 studies at 6% (95% CI: 3%–9%). Transradial access failure was reported in four studies, with a rate of 0% (95% CI: 0%–0%). Cannulation failure resulted in a rate of 4% (95% CI: 2%–7%). Asymptomatic radial artery occlusion (ARAO) occurred at a rate of 2% based on eight studies (95% CI: 0%–5%). Forearm hematoma was reported in 10 studies, with an occurrence of 1% (95% CI: 0%–2%). Cerebral vascular attacks (CAV) within 30 days were assessed in 13 studies, indicating a 2% occurrence (95% CI: 1%–2%). Conclusion: The findings suggest that TRA for CAS yields promising outcomes with high success rates and low complication rates. Further research should focus on randomized controlled trials and long-term outcomes to validate and extend findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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