Transradial access in interventional gynecology and obstetrics: Current evidence, clinical applications, and future directions

Transradial access (TRA) has emerged as a transformative approach in interventional cardiology and is increasingly being adopted in peripheral vascular interventions, including gynecological and obstetric procedures. Traditionally performed via transfemoral access (TFA), uterine artery embolization (UAE) and other pelvic interventions require prolonged bed rest and carry inherent access-site complications. This review synthesizes current evidence on the feasibility, safety, and clinical efficacy of TRA in interventional gynecology and obstetrics, covering UAE for fibroids, management of obstetric and gynecological hemorrhage, technical considerations, and future directions. A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library for studies published up to 2025. Meta-analyses demonstrate that TRA is a safe and effective alternative to TFA for UAE, with advantages including reduced radiation exposure (MD −207.54 mGy), shorter procedure times (MD −7.38 min), and higher likelihood of same-day discharge (RR 9.50). In obstetric and gynecological hemorrhage, cohort data support comparable efficacy with improved patient quality of life. A ten-year single-center experience reported a 97.35% angiographic success rate and a 7% mild complication rate. TRA offers particular advantages in obstetric patients, including immediate ambulation, reduced radiation exposure, and preserved fertility. However, the steeper learning curve, risk of radial artery occlusion, and limited long-term data remain challenges. Wider adoption requires structured training programs and further prospective studies. TRA represents a promising paradigm shift in interventional gynecology and obstetrics, offering comparable efficacy to TFA with potential advantages in radiation reduction, faster recovery, and improved patient comfort.