{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T17:32:49Z","timestamp":1773509569954,"version":"3.50.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Carotid artery stenting (CAS) has emerged as a viable alternative to carotid endarterectomy for managing carotid artery stenosis in high\u2010risk patients. Although transfemoral arterial access remains the preferred method, it is associated with inherent limitations and potential complications. Consequently, exploring transradial artery access as a potential option becomes crucial in optimizing patient outcomes and procedural success rates. There are limited data comparing the outcomes of the transradial with the transfemoral approach for CAS. This study aimed to systematically review and meta\u2010analyze the outcomes and complication rates between transradial and transfemoral access for CAS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">A systematic electronic search was conducted in 4 databases. Studies with randomized or nonrandomized designs, involving CAS by the transradial or transfemoral approach, were included. Outcomes of interest were stroke, transient ischemic attack, death, myocardial infarction, and access site complications. A meta\u2010analysis was performed, analyzing pooled odds ratios (ORs) and 95% CIs to assess the effect size.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Six studies with a total of 6917 patients were included, of whom 602 (8.7%) underwent the transradial approach and 6315 (91.3%) the transfemoral approach. The meta\u2010analysis showed no significant difference in stroke occurrence between the transradial and transfemoral groups (transradial:1.7% versus transfemoral:1.9%; OR = 0.98 [95% CI, 0.49\u20131.96]; I\n              <jats:sup>2<\/jats:sup>\n              = 0%). Similarly, no significant difference was found in death (TR:1% versus transfemoral:0.9%; OR = 0.95 [95% CI, 0.38\u20132.37]; I\n              <jats:sup>2<\/jats:sup>\n              = 0%), myocardial infarction (transradial:0.2% versus transfemoral:0.3%; OR = 1.53 [95% CI, 0.20\u201311.61]; I\n              <jats:sup>2<\/jats:sup>\n              = 0%), transient ischemic attack (transradial:0.4% versus transfemoral:1%; OR = 0.46 [95% CI, 0.11\u20131.95]; I\n              <jats:sup>2<\/jats:sup>\n              = 0%), or access site complications (transradial:2.2% versus transfemoral:1%; OR = 0.97 [95% CI, 0.48\u20131.98]; I\n              <jats:sup>2<\/jats:sup>\n              = 0%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">No significant differences were observed in stroke, death, myocardial infarction, transient ischemic attack, or access site complications on comparing thetransradial and transfemoral approaches for CAS. The transradial 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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.123.001156","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T05:13:22Z","timestamp":1703740402000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"4","author":[{"given":"Aaron","family":"Rodriguez\u2010Calienes","sequence":"first","affiliation":[{"name":"Department of Neurology University of Iowa Hospitals and Clinics Iowa City IA"},{"name":"Neuroscience, Clinical Effectiveness and Public Health Research Group Universidad Cient\u00edfica del Sur Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian A.","family":"Chavez\u2010Ecos","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de Estudiantes de Medicina de Ica Universidad Nacional San Luis Gonzaga Ica Peru"},{"name":"Red de Eficacia Cl\u00ednica y Sanitaria, REDECS Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Espinosa\u2010Martinez","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Escuela de Medicina Universidad C\u00e9sar Vallejo Trujillo Peru"},{"name":"Sociedad Cient\u00edfica de Estudiantes de Medicina de la Universidad C\u00e9sar Vallejo Trujillo Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Bustamante\u2010Paytan","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Humana Universidad de San Martin de Porres Lima Peru"},{"name":"Instituto Peruano de Neurociencias Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Vivanco\u2010Suarez","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Iowa Hospitals and Clinics Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagheli Fernanda","family":"Borjas\u2010Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Grupo Estudiantil de Investigaci\u00f3n en Neurociencias Sociedad de Estudiantes de Medicina de la Universidad de San Mart\u00edn de Porres Lima Peru"},{"name":"Abdulrauf University of Neurosurgery CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milagros","family":"Galecio\u2010Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Iowa Hospitals and Clinics Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Mor\u00e1n\u2010Mari\u00f1os","sequence":"additional","affiliation":[{"name":"Unidad de investigaci\u00f3n en Bibliometr\u00eda, Vicerrectorado de Investigaci\u00f3n Universidad San Ignacio de Loyola Lima Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waldo R.","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Neurology and Brain Repair University of South Florida Tampa FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3408-1297","authenticated-orcid":false,"given":"Santiago","family":"Ortega\u2010Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosurgery &amp; Radiology University of Iowa Hospitals and Clinics Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.003390"},{"key":"e_1_3_2_3_2","first-page":"119","article-title":"Guidelines on the diagnosis and treatment of extracranial carotid artery stenosis from the Italian Society for Vascular and Endovascular Surgery","volume":"55","author":"Setacci C","year":"2014","unstructured":"Setacci C, Argenteri A, Cremonesi A, de Donato G, Galzerano G, Lanza G, Navarretta F, Pulli R, Ricci S, Sbarigia E, et\u00a0al. 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