Objectives : To compare efficacy and safety of the Transradial approach (TRA) with that of the transfemoral approach (TFA) in uterine artery embolization (UAE) for the management of uterine fibroids.
Methods: We searched PubMed, SCOPUS, and Web of Science for relevant clinical trials and observational studies. Quality
appraisal was evaluated according to GRADE and we assessed the risk of bias of the trials using Cochrane's risk of bias tool.  Observational studies were evaluated according to the National Heart, Lung, and Blood Institute (NHLB).
Results: We included a total of four studies one of them is a RCT and the others are obsrvitional studies. The pooled analysis showed that TRA was associated with a significant reduction of the procedure time (MD= -7.13 [-9.92, -4.35], (P = 0.001).  There is no significant difference between both groups regarding the fluoroscopy time (MD= -1.07 [-3.92, 1.78], (P = 0.46), radiation exposure (MD= -0.14 [-0.35, 0.08]), (P = 0.21), major access site complications (OR= 0.66 [0.24, 1.85], (P = 0.43), and minor access site complications (OR= 0.69 [0.33, 1.43]), (P = 0.32).
Conclusion: Transradial and transfemoral approaches have the same safety and efficacy but the transradial was associated
with a short duration of the procedure.