Safety and technical success of transradial access in prostatic artery embolisation: a systematic review and meta-analysis
Date
2026
Authors
Brummer, N.
Chau, M.
White, S.J.
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Journal article
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Clinical Radiology, 2026; 95:107273-1-107273-50
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Nicholas Brummer, Minh Chau, Samuel J. White
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Abstract
Objectives 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 ten or more adult patients were included. The primary efficacy outcome was technical success, defined as bilateral PAE meaning successful embolization 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 GRADE framework was used to assess the strength of evidence. Results Six retrospective studies were included in this review (n=1208 patients). 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 (I2 = 41.3%). 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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Crown Copyright © 2026 Published by Elsevier Ltd on behalf of The Royal College of Radiologists. All rights are reserved, including those for text and data mining, AI training, and similar technologies