Transradial Versus Transfemoral Access In Patients With Hepatic Malignancy And Undergoing Hepatic Interventions:a Systematic Review And Meta-analysis

Aim: The aim of this study was to compare transradial access(TRA)approach with transfemoral access(TFA)approach in patients undergoing hepatic interventionsMethods: We conducted a comprehensive search of the PubMed,EMBASE,and the Cochrane Library database to identify relevant available articles.Patients’ preference,success rate,intra-and postoperative outcomes were analyzed.Both the RD(risk difference),RR(Relative Risk)and WMD(Weighted mean differences)values were reported with 95% CI(confidence intervals).We used RevMan 5.3 to perform the pooled analyses.Results: Nine cohort studies were included.1096 procedures were performed in 877 patients.Of those,545 procedures(49.7%)were performed by TRA,551 procedures(50.3%)were performed by TFA.Patients were significantly prefer the TRA(86.5%)to the TFA(13.5%)(RD= 0.88,P <0.00001).The procedure time in TRA groups was longer(WMD=3.36,95% CI 1.24,5.47,P=0.002).But there were no significant difference in terms of success rate,fluoroscopy time,radiation dosage,contrast volume and postoperative vascular complications.Conclusions: For patients suffer from primary or secondary hepatic malignancy and undergoing hepatic interventions,the present meta-analysis demonstrated that patients prefer the TRA approach to the TFA approach.But the procedure time is longer in TRA group.