TY - JOUR
T1 - Meta-analysis of stroke after transradial versus transfemoral artery catheterization
AU - Patel, Vishal G.
AU - Brayton, Kimberly M.
AU - Kumbhani, Dharam J.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
Dr. Banerjee: Speakers' Bureau for St. Jude Medical Center, Medtronic Corp., and Johnson & Johnson; research grant from Boston Scientific.
Funding Information:
Dr. Brayton: Supported by Grant Number HS000028 from the NIH; the contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the AHRQ.
PY - 2013/10/15
Y1 - 2013/10/15
N2 - 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.
AB - 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.
KW - Catheterization
KW - Stroke
KW - Transradial
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U2 - 10.1016/j.ijcard.2013.08.026
DO - 10.1016/j.ijcard.2013.08.026
M3 - Article
C2 - 23993322
AN - SCOPUS:84887204359
SN - 0167-5273
VL - 168
SP - 5234
EP - 5238
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 6
ER -