PT  - JOURNAL ARTICLE
AU  - Shapiro, S.Z.
AU  - Sabacinski, K.A.
AU  - Mantripragada, K.
AU  - Shah, S.S.
AU  - Stein, A.A.
AU  - Echeverry, N.B.
AU  - MacKinnon, G.A.
AU  - Snelling, B.M.
TI  - Access-Site Complications in Mechanical Thrombectomy for Acute Ischemic Stroke: A Review of Prospective Trials
AID  - 10.3174/ajnr.A6423
DP  - 2020 Feb 20
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2020/02/20/ajnr.A6423.short
4100  - http://www.ajnr.org/content/early/2020/02/20/ajnr.A6423.full
AB  - BACKGROUND: A shift has occurred in interventional cardiology from transfemoral to transradial access due to a 70%–80% decrease in complications. This shift has not yet taken place in other interventional specialties, perhaps owing to the lack of generalizability of findings in the cardiology data.PURPOSE: Our aim was to assess data from the recent mechanical thrombectomy prospective trials to better understand the access-site complication rate.DATA SOURCES: Articles were systematically sourced from the National Center for Biotechnology Information PubMed archive.STUDY SELECTION: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, prospective, randomized controlled trials published after 2008 with mention of major and/or minor femoral access-site complications in neuroendovascular mechanical thrombectomies were included.DATA ANALYSIS: Major and minor femoral access-site complications were extracted. A total complication rate was calculated with major access-site complications alone and combined with minor access-site complications.DATA SYNTHESIS: Seven prospective studies of 339 total screened met the inclusion criteria. Eleven major access-site complications were identified in of 660 total interventions, revealing a major access-site complication rate of 1.67% for patients undergoing mechanical thrombectomy with transfemoral access. If minor access-site complications were included, 35 total incidents were detected in 763 interventions, resulting in a total complication rate of 4.59%.LIMITATIONS: Multiple unspecified vessel and procedure-related complications were mentioned in the studies.CONCLUSIONS: The overall rate of major access-site complications was 1.67% in this review, which is not low and poses a risk to patients. We suggest further investigation into the feasibility and complication rates of alternative access sites for neurointerventional procedures.PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analysis