Transradial approach for carotid artery stenting: a feasibility study

Area of Science:

• Interventional Cardiology
• Vascular Surgery
• Neurology

Background:

• Carotid artery stenting (CAS) is an alternative to carotid endarterectomy for internal carotid artery (ICA) revascularization in high-risk patients.
• Femoral access for CAS can lead to complications and technical difficulties, particularly with peripheral vascular disease or complex aortic anatomy.
• The transradial approach is being evaluated as a potentially safer and more feasible alternative for CAS.

Purpose of the Study:

• To assess the feasibility and safety of using the radial artery as an alternative access site for carotid artery stenting (CAS).

Main Methods:

• Forty-two high-risk patients with >80% carotid artery stenosis underwent CAS.
• The common carotid artery (CCA) was accessed via the radial artery using specialized catheters and guidewires.
• Standard CAS techniques were employed, with bivalirudin used for anticoagulation.

Main Results:

• CAS was successful in 83% of patients (35/42).
• No radial access site complications were reported.
• One patient experienced a transient stroke with complete symptom resolution; median hospital stay was 2 days.

Conclusions:

• Transradial CAS is a safe and technically feasible procedure.
• This approach may be particularly beneficial for patients with right ICA lesions, severe peripheral vascular disease, unfavorable aortic arch anatomy, or a bovine aortic arch.