{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:35:38Z","timestamp":1790638538284,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Uterine artery embolization (UAE) is a well-established, minimally invasive treatment for symptomatic uterine fibroids. Traditionally performed through transfemoral access (TFA), there has been growing interest in the transradial approach (TRA) due to its reported benefits in other interventional procedures. This systematic review and meta-analysis aim to compare TRA and TFA in UAE for uterine fibroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Ovid MEDLINE, and Google Scholar was conducted from their date of inception to April 2025. Data were synthesized and analyzed using Review Manager. Risk of bias was assessed using the MINORS and RoB 2 tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f639 patients) met the inclusion criteria. Of these, 324 (50.7%) patients were assigned to the TRA group, with a mean age of 43.48\u202f\u00b1\u202f6.23\u202fyears, and 315 (49.3%) patients to the TFA group, with a mean age of 42.97\u202f\u00b1\u202f6.33\u202fyears. TRA was associated with significantly lower radiation exposure (MD\u202f=\u202f\u2212207.54\u202fmGy, 95% CI [\u2212262.42, \u2212152.67],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), shorter procedure time (MD\u202f=\u202f\u22127.38\u202fmin, 95% CI [\u221210.09, \u22124.66],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), and a greater likelihood of same-day discharge (RR\u202f=\u202f9.50, 95% CI [3.76, 24.03],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001). TRA also showed fewer access-site complications (RR\u202f=\u202f0.55, 95% CI [0.31, 0.97],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.04), particularly hematomas (RR\u202f=\u202f0.32, 95% CI [0.14, 0.74],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.007). No significant difference was found in fluoroscopy time. Moreover, the TRA failure rate was low (0.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TRA is a safe and effective alternative to TFA for UAE in selected settings, providing reduced radiation exposure, shorter procedure times, faster recovery, and fewer access-site complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251027231<\/jats:uri>\n                      , CRD420251027231.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1718480","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:40:39Z","timestamp":1772779239000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Transradial versus transfemoral access in uterine artery embolization for fibroids: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Zainah Abdulbari","family":"Alhebshi","sequence":"first","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwah Nasir","family":"Ahmad","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam Amro","family":"Alsayed","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layan Hassan","family":"Aljarari","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Rawah","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnoor","family":"Hayat","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina Khalid Mohammed","family":"Fadl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]},{"name":"Faculty of Medicine, University of Khartoum","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Daoud","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Medicine Practice Program, Batterjee Medical College","place":["Aseer, Saudi Arabia"]},{"name":"Faculty of Medicine, Al Neelain University","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omnia Orabi Mohammed","family":"Orabi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]},{"name":"Faculty of Medicine, Suez Canal University","place":["Ismailia, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma Mohammed Hassan","family":"Eltayeb","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tawam Hospital","place":["AlAin, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1111\/1471-0528.14640","article-title":"Epidemiology of uterine fibroids: a systematic review","volume":"124","author":"Stewart","year":"2017","journal-title":"BJOG"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.21037\/gpm-23-57","article-title":"Uterine fibroids: a narrative review of epidemiology and management, with a focus on uterine artery embolization","volume":"7","author":"Behairy","year":"2024","journal-title":"Gynecol Pelvic Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26502\/jrci.2809105","article-title":"Uterine artery embolization: a growing pillar of gynecological intervention","volume":"8","author":"Balamurugan","year":"2025","journal-title":"J Radiol Clin Imaging"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1046\/j.1471-0528.2002.01449.x","article-title":"Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up","volume":"109","author":"Walker","year":"2002","journal-title":"BJOG"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"488","DOI":"10.4103\/ijri.IJRI_204_16","article-title":"Endovascular uterine artery interventions","volume":"27","author":"Das","year":"2017","journal-title":"Indian J Radiol Imaging"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1007\/s00330-004-2515-x","article-title":"Uterine artery embolisation for uterine fibroids using a 4F Rosch inferior mesenteric catheter","volume":"15","author":"Ho","year":"2005","journal-title":"Eur Radiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2867","DOI":"10.21608\/ebwhj.2023.186446.1228","article-title":"Transradial versus transfemoral access for uterine artery embolization: a systematic review and meta-analysis","volume":"90","author":"Dawoud","year":"2023","journal-title":"Egypt J Hosp Med"},{"key":"ref8","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins","year":"2019"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2046-4053-1-7","article-title":"Why prospective registration of systematic reviews makes sense","volume":"1","author":"Stewart","year":"2012","journal-title":"Syst Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (MINORS): development and validation of a new instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1177\/02841851241297818","article-title":"Comparison of the transradial and transfemoral approaches for uterine artery embolization: a randomized clinical trial","volume":"66","author":"Bessar","year":"2025","journal-title":"Acta Radiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e672","DOI":"10.5114\/pjr.2022.123790","article-title":"Transradial versus transfemoral arterial access in the uterine artery embolization of fibroids","volume":"87","author":"Ghosh","year":"2022","journal-title":"Pol J Radiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"579","DOI":"10.3889\/oamjms.2019.163","article-title":"Uterine fibroid embolization via transradial versus transfemoral arterial access: technical results","volume":"7","author":"Gjoreski","year":"2019","journal-title":"Open Access Maced J Med Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"59","DOI":"10.5152\/dir.2020.19574","article-title":"A randomized comparison of transradial and transfemoral access in uterine artery embolization","volume":"27","author":"Khayrutdinov","year":"2021","journal-title":"Diagn Interv Radiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00270-018-2100-3","article-title":"Prospective study on total fluoroscopic time in patients undergoing uterine artery embolization: comparing transradial and transfemoral approaches","volume":"42","author":"Mortensen","year":"2019","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.jvir.2019.08.016","article-title":"Transradial and transfemoral uterine fibroid embolization comparative study: technical and clinical outcomes","volume":"31","author":"Nakhaei","year":"2020","journal-title":"J Vasc Interv Radiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S173","DOI":"10.1016\/j.jvir.2022.12.457","article-title":"Comparison of safety and feasibility of prostate artery embolization via transradial access versus transfemoral access: a single-center experience","volume":"34","author":"Richardson","year":"2023","journal-title":"J Vasc Interv Radiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1016\/S0140-6736(11)60404-2","article-title":"Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial","volume":"377","author":"Jolly","year":"2011","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2192","DOI":"10.1016\/S0140-6736(15)00305-0","article-title":"Radiation exposure in relation to the arterial access site used for diagnostic coronary angiography and percutaneous coronary intervention: a systematic review and meta-analysis","volume":"386","author":"Plourde","year":"2015","journal-title":"Lancet"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1007\/s00270-024-03865-z","article-title":"Comparative analysis of transradial and transfemoral approaches in transarterial radioembolization for liver tumors: a systematic review and meta-analysis","volume":"47","author":"Eldeeb","year":"2024","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"975","DOI":"10.2214\/AJR.20.23343","article-title":"Single-system experience with outpatient transradial uterine artery embolization: safety, feasibility, outcomes, and early rates of return","volume":"216","author":"Sher","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.jvir.2015.10.026","article-title":"Transradial approach for noncoronary interventions: a single-center review of safety and feasibility in the first 1,500 cases","volume":"27","author":"Posham","year":"2016","journal-title":"J Vasc Interv Radiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1055\/s-0041-1737026","article-title":"Access route for endovascular neurointervention\u2014transfemoral to transradial: is it worth the effort and are we ready for the change?","volume":"6","author":"Ahuja","year":"2022","journal-title":"J Clin Interv Radiol ISVIR"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"65","DOI":"10.4103\/bc.bc_38_20","article-title":"Dual-center study comparing transradial and transfemoral approaches for flow diversion treatment of intracranial aneurysms","volume":"7","author":"Khandelwal","year":"2021","journal-title":"Brain Circ"}],"updated-by":[{"DOI":"10.3389\/fmed.2026.1830166","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000}}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1718480\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T16:28:55Z","timestamp":1774456135000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1718480\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":26,"alternative-id":["10.3389\/fmed.2026.1718480"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1718480","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"article-number":"1718480"}}