AIM Peri-cardiac catheterization (CC) stroke is associated with increased morbidity and mortality. Little is known about any potential difference in stroke risk between transradial (TR) and transfemoral (TF) approaches. We explored this question through a systematic review and meta-analysis. METHODS MEDLINE, EMBASE, and PubMed were searched from 1980 to June 2022. Randomized trials and observational studies comparing radial versus femoral access CC or intervention that reported stroke events were included. A random-effects model was used for analysis. RESULTS The total population in our 41 pooled studies comprised 1 112 136 patients - average age 65 years, women averaging 27% in TR and 31% in TF approaches. Primary analysis of 18 randomized-controlled trials (RCTs) that included a total of 45 844 patients showed that there was no statistical significance in stroke outcomes between the TR approach and the TF approach [odds ratio (OR) 0.71, 95% confidence interval (CI) 0.48-1.06, P -value = 0.013, I2 = 47.7%]. Furthermore, meta-regression analysis of RCTs including procedural duration between those two access sites showed no significance in stroke outcomes (OR 1.08, 95% CI 0.86-1.34, P -value = 0.921, I2 = 0.0%). CONCLUSIONS There was no significant difference in stroke outcomes between the TR approach and the TF approach.

中文翻译：

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冠状动脉介入治疗中桡动脉入路与股动脉入路的卒中风险：更新的系统评价和荟萃分析。

目的 心包导管插入术 (CC) 中风与发病率和死亡率增加相关。人们对经桡动脉 (TR) 和经股动脉 (TF) 入路之间中风风险的潜在差异知之甚少。我们通过系统回顾和荟萃分析探讨了这个问题。方法 检索了 1980 年至 2022 年 6 月期间的 MEDLINE、EMBASE 和 PubMed。纳入了比较桡动脉与股动脉入路 CC 或报告卒中事件的干预措施的随机试验和观察性研究。使用随机效应模型进行分析。结果 我们 41 项汇总研究的总人口包括 1 112 136 名患者，平均年龄 65 岁，TR 方法中女性平均占 27%，TF 方法中女性平均占 31%。对总共纳入 45 844 名患者的 18 项随机对照试验 (RCT) 的初步分析表明，TR 方法和 TF 方法之间的卒中结果没有统计学意义 [比值比 (OR) 0.71，95% 置信区间 ( CI) 0.48-1.06，P 值 = 0.013，I2 = 47.7%]。此外，随机对照试验的荟萃回归分析（包括这两个进入部位之间的手术持续时间）显示对卒中结果没有显着影响（OR 1.08，95% CI 0.86-1.34，P 值 = 0.921，I2 = 0.0%）。结论 TR 方法和 TF 方法之间的卒中结果没有显着差异。