{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:37:12Z","timestamp":1788449832318,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to evaluate the risk of procedural complications after TAVR using secondary radial access (RA) versus femoral access (FA) through a systematic review and meta\u2010analysis of the published literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) entails both large\u2010bore arterial access for device delivery and secondary arterial access for hemodynamic and imaging assessments. It is unknown whether RA versus FA for this secondary access reduces the risk of procedural complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Embase, the Cochrane Library, and Web of Science for observational studies comparing TAVR procedural complications in RA versus FA. Event rates were compared via weighted summary odds ratios using the Mantel\u2013Haenszel method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six manuscripts encompassing 6132 patients were included. Meta\u2010analysis showed that RA reduced the risk of major vascular complications (OR 0.58, 95% CI 0.43\u20130.77, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%) and major\/life\u2010threatening bleeding (OR 0.46, 95% CI 0.36\u20130.59, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%) as compared to FA for secondary TAVR access. We also observed a reduction 30\u2010day mortality (OR 0.55, 95% CI 0.38\u20130.79, <jats:italic>p<\/jats:italic>\u00a0=\u20090.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%), acute kidney injury (OR 0.45, 95% CI 0.34\u20130.60, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%), and stroke and transient ischemic attack (OR 0.43, 95% CI 0.27\u20130.67, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RA reduced the risk of major vascular and bleeding complications when compared to FA for secondary access in TAVR. RA is associated with reduced risk of other adverse outcomes including mortality, but these associations may be related to selection bias and confounding given the observational study designs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30009","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T11:28:52Z","timestamp":1637234932000},"page":"1225-1233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Radial versus femoral secondary access for transcatheter aortic valve replacement: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-023X","authenticated-orcid":false,"given":"Thomas M.","family":"Das","sequence":"first","affiliation":[{"name":"Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rani K.","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X17697832"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-012-0842-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.09.009"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27043"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31714-8"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.06.017"},{"key":"e_1_2_7_10_1","article-title":"The impact of transradial secondary access on transcatheter aortic valve replacement outcomes: a systematic review and 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