Meta-analysis of stroke after transradial versus transfemoral artery catheterization

Fluctuating drowsiness following cardiac catheterisation: artery of Percheron ischaemic stroke causing bilateral thalamic infarcts

“…Specific procedural risk factors include long procedural times, emergency procedures, high contrast use, retrograde catheterisation of the left ventricle in patients with aortic stenosis, bypass graft procedures, presence of coronary thrombus and use of an intra-aortic balloon pump 1–3. There is no significant difference in the incidence of stroke between transradial or transfemoral cardiac catheterisation 4. There have been some reports that there is a disproportionately high incidence of posterior circulation strokes in cardiac catheterisation-related stroke,5 6 however the most recent large-scale study does not support this observation indicating an incidence of posterior circulation stroke of 23.8% in cardiac catheterisation-related stroke,7 which is comparable with their incidence among the general population 8…”

Clinical factors associated with physician choice of femoral versus radial access: A real‐world experience from a single academic center

“…It is worth noting that the there is a consensus that radial artery catheterization increases risk of stroke (subgroup analysis of the ACCOAST study). However, two meta‐analysis done by Sirker et al and Patel et al has not shown this . The perception that radial access increases stroke risk may have played a factor into preferential upfront femoral access in patients with history of CVD although it was not evident in the questionnaire administered (Figure B).…”

“…However, two meta-analysis done by Sirker et al and Patel et al has not shown this. [9][10][11] The perception that radial access increases stroke risk may have played a factor into preferential upfront femoral access in patients with history of CVD although it was not evident in the questionnaire administered ( Figure 1B). It is plausible that patients with CVD also has other comorbid conditions that influences physician preference.…”

Percutaneous Endovascular Aneurysm Repair: Current Status and Future Trends

“…A theoretical risk of CVA does exist from this access technique, but large analyses have not shown there to be a significantly increased risk over transfemoral access. 29 Careful evaluation of the patient is crucial for radial access to limit complications including radial artery occlusion and hand ischemia. Fischman et al provided an outstanding review of radial artery access considerations 30 and conclude the only absolute contraindication for transradial access is Barbeau type D waveforms signifying an incomplete palmar arch with potential for digital ischemia.…”