Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis
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 potentia...
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Wiley
2023-11-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.220 |
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| author | Aaron Rodriguez‐Calienes Fabian A. Chavez‐Ecos David Espinosa‐Martinez Diego Bustamante‐Paytan Nagheli Fernanda Borjas‐Calderón Milagros Galecio‐Castillo Juan R. Vivanco‐Suarez Waldo Guerrero R Santiago Ortega‐Gutierrez |
| author_facet | Aaron Rodriguez‐Calienes Fabian A. Chavez‐Ecos David Espinosa‐Martinez Diego Bustamante‐Paytan Nagheli Fernanda Borjas‐Calderón Milagros Galecio‐Castillo Juan R. Vivanco‐Suarez Waldo Guerrero R Santiago Ortega‐Gutierrez |
| author_sort | Aaron Rodriguez‐Calienes |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-b2bfda8cbfcf473cb653878e99f6294e |
| institution | OA Journals |
| issn | 2694-5746 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-b2bfda8cbfcf473cb653878e99f6294e2025-08-20T02:25:50ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-11-013S210.1161/SVIN.03.suppl_2.220Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysisAaron Rodriguez‐Calienes0Fabian A. Chavez‐Ecos1David Espinosa‐Martinez2Diego Bustamante‐Paytan3Nagheli Fernanda Borjas‐Calderón4Milagros Galecio‐Castillo5Juan R. Vivanco‐Suarez6Waldo Guerrero R7Santiago Ortega‐Gutierrez8Department of Neurology University of Iowa Hospitals and Clinics Iowa United StatesSociedad Científica de Estudiantes de Medicina de Ica Universidad Nacional San Luis Gonzaga Ica PeruSociedad Científica de Estudiantes de Medicina de Ica Universidad Nacional San Luis Gonzaga Trujillo PeruFacultad de Medicina Humana Universidad de San Martin de Porres Lima PeruGrupo Estudiantil de Investigación en Neurociencias Sociedad de Estudiantes de Medicina de la Universidad de San Martín de Porres Lima PeruDepartment of Neurology University of Iowa Hospitals and Clinics Iowa United StatesDepartment of Neurology University of Iowa Hospitals and Clinics Iowa United StatesDepartment of Neurology and Brain Repair University of South Florida Florida United StatesDepartment of Neurology Neurosurgery & Radiology University of Iowa Hospitals and Clinics Iowa United StatesIntroduction 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.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.220 |
| spellingShingle | Aaron Rodriguez‐Calienes Fabian A. Chavez‐Ecos David Espinosa‐Martinez Diego Bustamante‐Paytan Nagheli Fernanda Borjas‐Calderón Milagros Galecio‐Castillo Juan R. Vivanco‐Suarez Waldo Guerrero R Santiago Ortega‐Gutierrez Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis Stroke: Vascular and Interventional Neurology |
| title | Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis |
| title_full | Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis |
| title_fullStr | Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis |
| title_full_unstemmed | Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis |
| title_short | Abstract 220: Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta‐analysis |
| title_sort | abstract 220 transradial access versus transfemoral approach for carotid artery stenting a systematic review and meta analysis |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.220 |
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