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Transradial access for prostate artery embolisation shows 96.5% technical success in meta-analysisTransradial access for prostate artery embolization shows high technical success in review

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Key Takeaway
Consider transradial access as a feasible alternative for prostate artery embolisation, pending prospective validation.

This systematic review and meta-analysis evaluated the safety and technical success of transradial access (TRA) for prostate artery embolisation (PAE). The analysis included six retrospective studies comprising 1208 adult patients. The primary comparator was transfemoral access (TFA) and other access sites. The primary outcome was technical success for bilateral PAE, with secondary outcomes including fluoroscopy time, procedure time, and radiation dose (air kerma).

The main finding was a technical success rate of 96.5% for TRA. The mean fluoroscopy time, procedure time, and air kerma for TRA were reported as comparable to other access sites, though specific numerical comparisons were not provided. Regarding safety, the analysis reported 53 minor complications (4.4%) and 4 major complications (0.3%) across the included studies. Discontinuations and tolerability were not reported.

Key limitations include the retrospective nature of all six included studies, moderate between-study heterogeneity (I² = 41.3%), and an overall moderate risk of bias. The strength of evidence was rated as moderate. The analysis establishes an association but not causation. For practice, TRA appears to be a feasible alternative access route for PAE with similar complication rates and procedure metrics to TFA. However, the evidence does not establish superiority of TRA over TFA, and further prospective, controlled studies are required for definitive comparison.

Researchers reviewed six existing studies to see if performing a prostate artery embolization (PAE) procedure through an artery in the wrist, called transradial access (TRA), is a safe and effective option. PAE is a minimally invasive treatment for an enlarged prostate. The review included data from 1,208 adult patients who had undergone the procedure.

The analysis found that using the wrist artery was technically successful in completing the procedure 96.5% of the time. The rates of complications were low, with major complications occurring in only 0.3% of patients and minor complications in 4.4%. Key measures like how long the procedure took and how much radiation was used were similar whether doctors used the wrist or the more traditional groin (transfemoral) access point.

It is important to be cautious because all the studies included in this review were retrospective, meaning they looked back at past patient records rather than planning the comparison in advance. This type of evidence is considered moderate in strength. The review shows TRA is a feasible alternative, but it does not prove it is better than the groin approach. More prospective, head-to-head studies are required to determine if one method is superior for patient outcomes.

What this means for you:
Wrist access for prostate embolization appears feasible and safe, but more direct comparison studies are needed.

Study Details

Study typeMeta analysis
Sample sizen = 1,208
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
AIM: Transradial access (TRA) has become an alternative vascular access site for a range of procedures in interventional radiology. The aim of this systematic review and meta-analysis was to assess the safety and technical success of TRA for prostate artery embolisation (PAE). MATERIALS AND METHODS: A systematic search of the Medline, Embase, and Scopus databases was performed in November 2024. Primary studies describing outcomes in TRA for PAE involving 10 or more adult patients were included. The primary efficacy outcome was technical success, defined as bilateral PAE meaning successful embolisation of both prostate arteries, and primary safety outcome was 30-day mortality. The ROBINS-I tool was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation framework was used to assess the strength of evidence. RESULTS: Six retrospective studies were included in this review (n=1208 patients). A random-effects meta-analysis was performed, demonstrating a 96.5 % technical success rate of TRA for PAE. Four (0.3 %) major complications and 53 (4.4 %) minor complications occurred. Mean fluoroscopy time, procedure time, and air kerma via TRA were all comparable to other access sites. Moderate between-study heterogeneity was present (I = 41.3 %). The overall risk of bias was moderate; however, no significant publication bias was present. The strength of evidence was moderate. CONCLUSION: The findings of this study support TRA as a feasible alternative access route for PAE with similar complication rates, procedure times, and radiation doses compared to transfemoral access (TFA). However, further prospective, controlled studies are required to evaluate TRA head-to-head with TFA to establish whether one approach is superior.
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