SYSTEMATIC REVIEW article
Front. Med.
Sec. Obstetrics and Gynecology
Transradial Versus Transfemoral Access in Uterine Artery Embolization for Fibroids: A Systematic Review and Meta-Analysis
Provisionally accepted
Zainah Abdulbari Alhebshi1*
Marwah Nasir Ahmad1Mariam Amro Alsayed1Layan Hassan Aljarari1Maya Rawah1Mahnoor Hayat1
Jina Khalid Mohammed Fadl2,3Ibrahim Daoud2,4Omnia Orabi Mohammed Orabi2,5Salma Mohammed Hassan Eltayeb6- 1General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia
- 2Department of Obstetrics and Gynecology, Batterjee Medical College, Jeddah, Saudi Arabia
- 3Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- 4Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
- 5Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- 6Department of Obstetrics and Gynecology, Tawam Hospital, Al Ain, United Arab Emirates
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Abstract Background: Uterine artery embolization (UAE) is a widely accepted minimally invasive treatment for symptomatic uterine fibroids. Traditionally performed via transfemoral access (TFA), there has been growing interest in the transradial approach (TRA) due to its reported benefits in other interventional procedures. This systematic review and meta-analysis compare TRA and TFA in UAE for uterine fibroids. Methods: A systematic search of PubMed, Ovid Medline, and Google Scholar was conducted up to April 2025. Data were synthesized and analyzed using Review Manager. Risk of bias was assessed using the MINORS and RoB 2 tools. Results: Six studies (n = 639 patients) met inclusion criteria. Of these, 324 (50.7%) patients were assigned to the TRA group, with a mean age of 43.48 ± 6.23 years, and 315 (49.3%) patients to the TFA group, with a mean age of 42.97 ± 6.33 years TRA was associated with significantly lower radiation exposure (MD = –207.54 mGy, 95% CI [–262.42, –152.67], P < 0.00001), shorter procedure time (MD = –7.38 minutes, 95% CI [–10.09, –4.66], P < 0.00001), and greater likelihood of same-day discharge (RR = 9.50, 95% CI [3.76, 24.03], P < 0.00001). TRA also showed fewer access-site complications (RR = 0.55, 95% CI [0.31, 0.97], P = 0.04), particularly hematomas (RR = 0.32, 95% CI [0.14, 0.74], P = 0.007). No significant difference was found in fluoroscopy time. TRA failure rate was low (0.3%). Conclusion: TRA is a safe and effective alternative to TFA for UAE in selected settings, offering reduced radiation exposure, shorter procedure times, faster recovery, and fewer access-site complications.
Keywords: interventional radiology, Minimally invasive therapy, Transfemoral access, Transradial access, Uterine Artery Embolization, Uterine fibroids
Received: 03 Oct 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Alhebshi, Ahmad, Alsayed, Aljarari, Rawah, Hayat, Fadl, Daoud, Orabi and Eltayeb. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zainah Abdulbari Alhebshi
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