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Published on: September 20, 2020
Transradial access for carotid artery stenting: a single-center experience
C Bakoyiannis1, K P Economopoulos, S Georgopoulos
1First Department of Surgery, Vascular Department, University of Athens, Laiko General Hospital, Athens, Greece. bakogian@hotmail.com
Insights
Transradial access for carotid artery stenting (CAS) is a safe and effective option for high-risk patients. This approach offers a 100% technical success rate with no major complications, making it a promising alternative to traditional methods.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenting (CAS) is a crucial procedure for stroke prevention.
- Traditional femoral access may be unsuitable for certain patients due to anatomical or pathological limitations.
Purpose of the Study:
- To evaluate the initial experience and feasibility of using the radial artery for CAS.
- To review the existing literature on transradial CAS.
Main Methods:
- A prospective study of nine high-risk patients undergoing CAS via radial artery access.
- Evaluation of major (stroke, TIA, MI, death) and minor (radial artery occlusion, hematoma) complications.
Main Results:
- 100% technical success rate in all nine patients.
- All patients were mobilized within two hours and discharged post-procedure.
- No major or minor complications were reported during the study period.
Conclusions:
- Transradial access is a viable alternative for CAS in patients with unfavorable iliofemoral or aortic anatomy.
- Further refinement of transradial techniques and devices may lead to its wider adoption, potentially replacing conventional femoral access.
Aim:
The aim of this study was to report our initial experience using the radial artery as access for carotid artery stenting (CAS) and review the existing literature.
Methods:
From January to June 2008, nine high-risk consecutive patients were treated with carotid stents by using the radial artery as an access point. Major complications (perioperative myocardial infarction, stroke, transient ischemic attack [TIAs] and death) and minor complications (radial artery occlusion or hematomas) were evaluated during this procedure.
Results:
Seven of these patients had a right (77.8%) and two had a left (22.2%) sided carotid artery stenosis. Patients were symptomatic (TIAs or strokes or both) and had a >60% stenosis of the internal carotid artery. The technical success rate was 100% and all patients mobilized two hours after the procedure and were discharged home on the first postoperative day. No major or minor complications were reported.
Conclusion:
Patients with vessel pathology or unfavorable anatomy in the iliofemoral arteries or/and the aorta, can be candidates for CAS through the radial artery. Refinement of the technique and improvement in endovascular devices may lead to the replacement of the conventional femoral access by the transradial route in the near future.