June 2, 2020
Large Study Compares Transradial and Transfemoral Approaches for Flow-Diverting Stent Placement
June 2, 2020—Transradial access (TRA) may be a safer approach than transfemoral access (TFA) for flow diversion procedures to treat cerebral aneurysms at a wide range of locations, concluded Yangchun Li, MD, et al in a study published online in Journal of NeuroInterventional Surgery (JNIS). In a retrospective analysis of a large series of patients, the investigators found that the access site and overall complication rates were lower for TRA flow diversion compared with TFA.
The investigators used a large multicenter registry to retrospectively analyze flow diversion cases for cerebral aneurysms from 14 institutions from 2010 to 2019. Pooled analysis of proportions was calculated using weighted analysis with 95% CI to account for results from multiple centers. Access site complication rates and overall complication rates were compared between the two approaches.
As summarized in JNIS, the study was composed of 2,285 patients who underwent flow diversion (TRA, n = 134 [5.86%]; TFA, n = 2,151 [94.14%]). The two groups shared similar patient and aneurysm characteristics. Crossover from TRA to TFA was documented in 12 (8.63%) patients.
There were no access site complications in the TRA group. There was a significantly higher access site complication rate in the TFA cohort compared with TRA (2.48% [95% CI, 2.4%-2.57%] vs 0%; P = .039). One death resulted from a femoral access site complication.
The overall complication rate was also higher in the TFA group (9.02%; 95% CI, 8.15%-9.89%) compared with the TRA group (3.73%; 95% CI, 3.13%-4.28%; P = .035), reported the investigators in JNIS.