What question did this study set out to answer?

This research aims to compare the safety and efficacy of transradial access (TRAC) versus transfemoral access (TFAC) during transcatheter aortic valve implantation (TAVI).

April 1, 2026

Outcomes of transradial versus transfemoral secondary access in transcatheter aortic valve implantation: a systematic review and meta-analysis

Q: What does this research mean for the field?

Transradial secondary access in transcatheter aortic valve implantation significantly reduces 30-day all-cause mortality, bleeding, and vascular complications compared to transfemoral access. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Resultado clave

Transradial secondary access in TAVI significantly reduced 30-day all-cause mortality (RR 0.45, 95% CI 0.36–0.57) compared to transfemoral access.

Puntos clave

This research aims to compare the safety and efficacy of transradial access (TRAC) versus transfemoral access (TFAC) during transcatheter aortic valve implantation (TAVI).
Performed a systematic review and meta-analysis of studies comparing TRAC and TFAC.
Included data from eight studies with 15,462 patients from various databases.
Evaluated primary and secondary endpoints such as mortality, stroke, and complications.
TRAC showed significantly lower all-cause mortality (RR 0.45).
Lower total (RR 0.44) and major (RR 0.51) bleeding events were noted in the TRAC group.
TRAC had lower total (RR 0.47) and major (RR 0.45) vascular complications.
The incidence of acute kidney injury was reduced in the TRAC group (RR 0.48).

PICO estructurado

Does transradial secondary access reduce 30-day all-cause mortality and complications compared to transfemoral secondary access in patients undergoing TAVI?

Población

15,462 patients undergoing transcatheter aortic valve implantation (TAVI) pooled from 8 studies, mean age ~81 years, 44-50% female.

Intervención

Transradial access (TRAC) for secondary access during TAVI

Comparador

Transfemoral access (TFAC) for secondary access during TAVI

Resultado

30-day all-cause mortalityhard clinical

Transradial secondary access during TAVI is associated with significantly lower 30-day all-cause mortality, bleeding, and vascular complications compared to transfemoral access.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Abstract Background Transcatheter aortic valve implantation (TAVI) requires both a primary access route for valve delivery and a secondary access for angiographic visualization. While transfemoral access (TFAC) is conventionally used, transradial access (TRAC) has recently emerged as a promising alternative. Purpose This systematic review and meta-analysis aimed to evaluate the comparative safety and efficacy of TRAC versus TFAC for secondary access in TAVI procedures. Methods A comprehensive literature search was performed using MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials databases from their inception through October 1, 2025. Studies comparing TRAC and TFAC for the secondary access for TAVI were included. The primary endpoint was the 30-day all-cause mortality. Secondary endpoints included 30-day stroke, acute kidney injury (AKI), total, life-threatening, and major bleeding events, as well as total, major, and minor vascular complications and the in-hospital length of stay. Results A total of eight studies including15,462 patients (3,319 in the TRAC group and 12,143 in the TFAC group) were included in this meta-analysis. The mean age was comparable between the two groups (81.19±6.67 in TRAC vs 81.53±6.36 years in TFAC). The proportion of females was 44% and 50.1%, respectively. The mean Society of Thoracic Surgeons (STS) score was 4.04±2.9 in the TRAC group and 4.4±2.83 in the TFAC group, while the prevalence of peripheral artery disease was 13.6% and 17.7%, respectively. All-cause mortality was significantly lower in the TRAC group compared with the TFAC group (RR 0.45, 95% CI 0.36–0.57). Both total (RR 0.44, 95% CI 0.30–0.66) and major (RR 0.51, 95% CI 0.30–0.87) bleeding events were significantly lower in the TRAC group, whereas life-threatening bleeding did not differ between the two groups (RR 0.66, 95% CI 0.32–1.34). Furthermore, total (RR 0.47, 95% CI 0.25–0.89) and major (RR 0.45, 95% CI 0.27–0.73) vascular complications were lower in the TRAC group, while minor vascular complications showed no significant difference between the two approaches. Finally, no significant difference was observed in 30-day stroke rates (RR 0.68, 95% CI 0.45–1.02), while the incidence of 30-day AKI was significantly reduced in the TRAC group (RR 0.48, 95% CI 0.38–0.60). Conclusions The findings of our meta-analysis indicate that the TRAC secondary access route in TAVI is associated with bettersafety outcomes compared with the TFAC, as it was associated with lower rates of all-cause mortality, vascular complications and bleeding. According to our findings, TRAC should be preferred as secondary access. Nevertheless, randomized studies are required to validate ourfindings and establish definitive clinical recommendations.For image description, please refer to the figure legend and surrounding text.

Me gusta

Guardar