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Background <p>Recent studies comparing transradial (TRA) and transfemoral access (TFA) in endovascular treatment of intracranial aneurysms have yielded inconclusive results. Due to its superficial course and fewer access-site complications, TRA may provide improved safety and efficacy. This study directly compares TRA and TFA for safety and effectiveness in treating intracranial aneurysms.</p> Methods <p>We systematically searched PubMed, Embase and Cochrane for clinical studies comparing TRA and TFA in endovascular treatment of intracranial aneurysms, including studies published through October 15, 2025. A random-effects meta-analysis was performed following PRISMA. Interstudy heterogeneity was assessed using I² and X² statistics (I²&gt;50%=significant heterogeneity).</p> Results <p>Seven studies involving 3,754 patients receiving TRA (444) or TFA (3,310) were included (age range: 52–68 years). Compared to TFA-treated patients, TRA-treated patients demonstrated significantly lower rates of access-site complications (risk ratio, 0.28; 95% CI, 0.12–0.65; <i>p</i> = 0.003), without an increased risk of intracranial hemorrhage (1.10; 0.53–2.30; <i>p</i> = 0.60) or stroke (0.86; 0.19–4.01; <i>p</i> = 0.85). TRA-treated patients showed similar rates of complete aneurysm occlusion (1.06, 0.87–1.27, <i>p</i> = 0.59) and all-cause mortality (0.89, 0.34–2.37, <i>p</i> = 0.82), but shorter procedure duration (− 13.59&#xa0;min, − 18.89 to − 8.28, <i>p</i> &lt; 0.00001) and reduced hospital stay (− 1.26 days, − 2.50 to − 0.02, <i>p</i> = 0.05).</p> Conclusion <p>TRA is superior to TFA in reducing access-site complications and is associated with shorter procedure duration and hospital stay without affecting aneurysm occlusion, intracranial hemorrhage, stroke, or mortality.</p>

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Transradial versus transfemoral access for intracranial aneurysm treatment: evidence from a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月2日

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  • Muhammad Waqar Shahid,
  • Sara Sharif,
  • Umama Malik,
  • Fatima Sajjad,
  • Meher Wali Khan,
  • Amir Zeb,
  • Khadija Rameen,
  • Sofia Abdullah,
  • Aaitain Ikram Ul Haq,
  • Amina Khan,
  • Ilyas,
  • Kainat Afzal,
  • Mahnoor Sheikh,
  • Sadia Shaheen,
  • Sherjeel Khan,
  • Faryal Khan,
  • Maeya Saleem,
  • Muhammad Waqas,
  • Saddam Hussain,
  • Abdullah Afridi,
  • Kamil Ahmad Kamil

摘要

Background

Recent studies comparing transradial (TRA) and transfemoral access (TFA) in endovascular treatment of intracranial aneurysms have yielded inconclusive results. Due to its superficial course and fewer access-site complications, TRA may provide improved safety and efficacy. This study directly compares TRA and TFA for safety and effectiveness in treating intracranial aneurysms.

Methods

We systematically searched PubMed, Embase and Cochrane for clinical studies comparing TRA and TFA in endovascular treatment of intracranial aneurysms, including studies published through October 15, 2025. A random-effects meta-analysis was performed following PRISMA. Interstudy heterogeneity was assessed using I² and X² statistics (I²>50%=significant heterogeneity).

Results

Seven studies involving 3,754 patients receiving TRA (444) or TFA (3,310) were included (age range: 52–68 years). Compared to TFA-treated patients, TRA-treated patients demonstrated significantly lower rates of access-site complications (risk ratio, 0.28; 95% CI, 0.12–0.65; p = 0.003), without an increased risk of intracranial hemorrhage (1.10; 0.53–2.30; p = 0.60) or stroke (0.86; 0.19–4.01; p = 0.85). TRA-treated patients showed similar rates of complete aneurysm occlusion (1.06, 0.87–1.27, p = 0.59) and all-cause mortality (0.89, 0.34–2.37, p = 0.82), but shorter procedure duration (− 13.59 min, − 18.89 to − 8.28, p < 0.00001) and reduced hospital stay (− 1.26 days, − 2.50 to − 0.02, p = 0.05).

Conclusion

TRA is superior to TFA in reducing access-site complications and is associated with shorter procedure duration and hospital stay without affecting aneurysm occlusion, intracranial hemorrhage, stroke, or mortality.