Radial vs. Femoral Approach for Treatment of Acute Hemorrhagic and Ischemic Stroke Patients

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Radial vs. Femoral Approach for Treatment of Acute Hemorrhagic and Ischemic Stroke Patients

Research Strategy:

  • The focus of this research was to identify clinical studies that have investigated the role of novel radial access compared to traditional femoral access in Neurovascular management (of Acute Hemorrhagic and Ischemic Stroke patients). Given that this data will be utilized for launching a product that utilized the novel radial approach, we wanted to limit our results to published scientific studies. Our approach for this research has been to summarize the relevant findings in a mini-systematic review format which has been outlined in the attached spreadsheet.
  • We used the PubMed search terms (outlined below) and obtained the following results:
    • 'Radial access AND Neurovascular': only 1 study that investigated the role of radial access for the diagnostic Cerebral Angiography.
    • 'Radial access AND Angiography': screened through all 125 studies, all of which focused on investigating the Transradial approach for use in coronary Angiography or acute coronary syndrome. Only relevant studies were incorporated in the attached google spreadsheet.
    • 'Radial access AND Stroke': obtained 38 hits, of which all studies focused on using the trans-radial approach for coronary Angiography or acute coronary syndrome.
    • 'Radial access AND Cerebral': obtained 12 hits of which only one study, however, revealed some insights into post-operative complications related to silent cerebral infarcts after cardiac catheterization comparing the Transradial versus Transfemoral approaches (included in the systematic review table).

  • Our research indicated that studies investigating the role of the Transradial approach for the management of Neurovascular conditions such as acute hemorrhage and Ischemic Stroke were lacking. In fact, the only relevant study (Stone JG. et. al., 2020) which was published in BMJ, claimed that the study is the first of its kind to investigate the efficacy, safety, and patient satisfaction amongst patients with Neurovascular conditions.
  • Additionally, we screened through the bibliographic references of the parent article (Stone JG. et. al., 2020) to identify scientific studies that investigated Patient Perception and Satisfaction or Safety/Efficacy of the Transradial approach for the management of neurovascular conditions.
  • We computed a separate heading for studies that investigated Patient Perception and Satisfaction in the Transradial approach, compared to the Transfemoral approach. Our research indicated that only one patient satisfaction study was investigated in a study population with Neurovascular conditions, while others have been studied in Cardiovascular conditions, which are also outlined in the table. Kindly find the results in the attached google spreadsheet.
  • Information pertaining to health economics (such as cost-benefit analysis and incremental cost-effectiveness ratios) could not be covered in this session; this was out of the scope for the three hours dedicated to this project. This area needs to be covered as a separate request. Our preliminary search indicated that information regarding this topic is easily available (but limited to cardiovascular conditions). For future requests, we recommend that a separate systematic review of studies should be considered to do justice to this area.



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