• Colin Son, Samon Tavakoli, and Vaidehi Mahadev.
• Neurosurgical Associates of San Antonio, University of Texas Health Science Center, San Antonio, Texas, USA. Electronic address: cts@saneuro.com.
• World Neurosurg. 2021 Jul 1; 151: 6-11.

BackgroundTransradial access is an increasingly popular route for cerebral angiography and neurointerventions. However, obstacles to wider adoption remain, especially for complex interventions typically performed with larger, multiaxial systems such as flow diversion. We sought to analyze the published evidence for transradial flow diversion of intracranial aneurysms.MethodsUsing Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a literature review was performed to identify all published reports and studies of transradial flow diversion for intracranial aneurysm. The search was limited from April 2011 to February 2021. Primary outcome was successful completion of the procedure via a transradial approach. Heterogeneity was analyzed with Q and I2 statistics. Secondary outcomes were transradial access-site complications and other complications.ResultsIn total, 11 studies involving 290 treated aneurysms were identified; 90.7% of the procedures were completed via the transradial approach. The heterogeneity between studies was high, with an I2 of 56.9%. There were no transradial access-site complications. The procedural complication rate was 2.41%.ConclusionsTransradial access has a high success rate for both anterior and posterior circulation flow-diversion embolizations. The success rate may be particularly high for posterior circulation and right anterior circulation aneurysms. It has a negligible access-site complication rate. Transradial access is a viable alternative to transfemoral access for flow diversion and should be considered as a first-line approach.Copyright © 2021 Elsevier Inc. All rights reserved.

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