title: Meta-analysis of stroke after transradial versus transfemoral artery catheterization.
abstract: BACKGROUND
  Transradial (TR) catheterization is gaining popularity due to its association with lower bleeding and access site complications, improved patient comfort, and lower costs compared to transfemoral (TF) catheterization; however, there is concern that TR catheterization may be associated with an increased risk of neurological complications. New randomized data has emerged since the publication of the last meta-analysis evaluating the risk of stroke between TR and TF catheterization in 2009.
  
  
  METHODS
  We conducted a meta-analysis of randomized studies published until 2013 reporting risk of stroke in TR vs. TF catheterization.
  
  
  RESULTS
  Data from 11,273 patients in 13 studies were collated. The majority of patients were men, and 8987 (79.7%) were enrolled in acute coronary syndrome trials. Very few patients had a history of prior coronary artery bypass grafting, and approximately 2/3 of patients underwent percutaneous coronary intervention. Stroke occurred in 25 of 5659 patients in the TR group, vs. 24 of 5614 patients in the TF group. There was no difference in stroke rates between the TR and TF groups (risk difference 0.00%, 95% confidence interval -0.29%-0.25%, p=0.88).
  
  
  CONCLUSIONS
  TR catheterization is not associated with a significant increase in stroke compared to TF catheterization.
authors.affiliation: VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Vishal G
authors.initials: VG
authors.lastname: Patel
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Brayton
authors.forename: Dharam J
authors.initials: DJ
authors.lastname: Kumbhani
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D017534:Radial Artery; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*
keywords: Catheterization; Stroke; Transradial