You Have to Read Between the Lines: a Bibliometric Analysis of Transradial and Transfemoral Access for Intracranial Aneurysms

Introduction: Traditionally, transfemoral access (TFA) has been the predominant access site in managing intracranial aneurysms (IAs). However, recent changes in vascular and cardiovascular guidelines recommend transradial access (TRA) as the first-line approach in endovascular procedures. Neuro-endovascular practice has been slow to employ radial-first modalities despite several studies affirming its low rates of complications and comparable results to TFA. This study aims to contextualize recent publication trends related to vascular accesses when treating IAs.

Methods: Two separate searches were done through the Web of Science Core Collection. Each search was limited to articles published from 1970 to 2023 that contained either in title/abstract the terms "Transfemoral/femoral" or "Transradial/radial" and "intracranial aneurysm." Publication trends, annual scientific production, and other metrics were extracted using Bibliometrix.

Results: The rate of publications on TRA has increased from 2017 to 2022 (104.3%) compared with those from 2011 to 2016 (65.2%). TRA-related articles reported a significantly higher annual growth rate (10.6%), with a median of 34 articles published yearly in the last five years. TFA had a lower annual growth (6.02%), with a median of 25 articles per year in the last five years. TFA also presented an older association with the keyword aneurysm, with the term's frequency peaking in 2006 versus 2019 for TRA, which further confirms the recent interest in TRA-related publications.

Conclusion : TRA-related research productivity is now comparable to TFA-related scientific production, with many articles published recently in high-impact journals. Our data suggests TRA vascular access is a trending topic in IAs management and might soon be a staple in future guidelines.