RA vs TFA in Uterine Artery Embolization: Systematic Review Highlights Safety and Efficiency

A new systematic review and meta-analysis comparing transradial access (TRA) with the traditional transfemoral access (TFA) in uterine artery embolization (UAE) suggests that TRA may offer important procedural and safety advantages for women undergoing treatment for symptomatic uterine fibroids.

The analysis, conducted according to PRISMA guidelines and registered in PROSPERO, pooled data from seven studies involving 710 patients (355 TRA and 355 TFA). Researchers evaluated procedural metrics, radiation exposure, and access site complications using robust risk-of-bias tools and random-effects modelling.

Key Findings
• TRA is a safe and effective alternative to TFA, offering comparable procedural success, procedural time, and fluoroscopy duration.
• Radiation exposure was notably lower with TRA in sensitivity analyses, showing a significant reduction (MD –0.16 Gy), highlighting a potential safety benefit.
• Fewer minor access site complications were observed with TRA, although the difference did not reach statistical significance. Major complications remained similar across both groups.
• Microcatheter use was slightly higher in the TRA cohort, but the difference was not statistically significant.

Overall, the findings underscore TRA as a minimally invasive, patient-friendly approach with emerging advantages in interventional gynaecology. As TRA continues to gain traction, it may increasingly complement or replace femoral access in UAE procedures, supporting enhanced patient comfort and potentially safer outcomes.