Batista Sávio, Oliveira Leonardo de Barros, Borges Jordana, Pinheiro Agostinho C, Filho José Alberto Almeida, Santana Laís Silva, Bertani Raphael, Koester Stefan, Hanel Ricardo
Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Medicine, State University of Ponta Grossa, Paraná, Brazil.
Interv Neuroradiol. 2023 Aug 18:15910199231194665. doi: 10.1177/15910199231194665.
The carotid artery stenting (CAS) has two common access sites: transradial access (TRA) and transfemoral access (TFA). However, there's no definitive answer to which one is superior.
Compare TRA and TFA for the CAS.
A systematic review of the literature of studies reporting both TRA and TFA results was conducted following the PRISMA guidelines. PubMed, Cochrane Library, Web of Science and Embase were queried.
The meta-analysis examined nine studies comprising 7513 patients who underwent CAS. Of these, 6750 patients had TFA (90%), while 763 had TRA (10%). There was no significant difference in procedure success rates between TRA and TFA, with a risk ratio (RR) of 0.99 (6/9; 95% CI 0.98 to 1.00; I² = 9%, fixed effects). However, cross-over to TFA was more frequent in TRA (odds ratio (OR) 10.37 (6/9; 95% CI 5.18 to 20.77; I² = 17%, fixed effects)). There were no significant differences in terms of major access complications (RR = 0.88 (7/9; 95% CI: 0.29 to 2.63; I² = 0, fixed effects)), total access complications (RR = 1.10 (6/9; 95% CI: 0.56 to 2.15; I² = 7%, fixed effects)), and mean difference in length of stay (Mean difference of -0.08 (3/9; 95% CI -0.18 to 0.02; I² = 0%, fixed effects)).
There were no significant differences between TFA and TRA in terms of procedure success rates, time, complications, and length of stay, although cross-over to TFA was more common in TRA cases.
颈动脉支架置入术（CAS）有两个常见的入路部位：经桡动脉入路（TRA）和经股动脉入路（TFA）。然而，对于哪一种更具优势尚无定论。
比较CAS的TRA和TFA。
按照PRISMA指南对报告了TRA和TFA结果的研究文献进行系统综述。检索了PubMed、Cochrane图书馆、科学网和Embase。
荟萃分析纳入了9项研究，共7513例接受CAS的患者。其中，6750例采用TFA（90%），763例采用TRA（10%）。TRA和TFA的手术成功率无显著差异，风险比（RR）为0.99（6/9；95%CI 0.98至1.00；I² = 9%，固定效应）。然而，TRA组转为TFA的情况更频繁（优势比（OR）为10.37（6/9；95%CI 5.18至20.77；I² = 17%，固定效应））。在主要入路并发症（RR = 0.88（7/9；95%CI：0.29至2.63；I² = 0，固定效应））、总入路并发症（RR = 1.10（6/9；95%CI：0.56至2.15；I² = 7%，固定效应））以及住院时间的平均差异（平均差异为-0.08（3/9；95%CI -0.18至0.02；I² = 0%，固定效应））方面均无显著差异。
TFA和TRA在手术成功率、时间、并发症和住院时间方面无显著差异，尽管TRA病例中转为TFA的情况更常见。
