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Updated: May 22, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
The transradial approach for carotid artery stenting
Nicholena Etxegoien1, Diana Rhyne, Sasko Kedev
1Wake Heart and Vascular Associates, Raleigh, North Carolina 27610, USA.
Insights
The transradial approach offers a viable alternative for carotid artery stenting (CAS), especially when femoral access is challenging. This study demonstrates its safety and effectiveness in a large patient cohort.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Neurology
Background:
- Carotid artery stenting (CAS) is an established alternative to carotid endarterectomy (CEA) for internal carotid artery (ICA) revascularization.
- Femoral access for CAS can be complicated by peripheral vascular disease, aortic arch anatomy, and access site issues.
Purpose of the Study:
- To evaluate the safety and efficacy of the right radial approach (RRA) for carotid artery stenting (CAS).
Main Methods:
- Retrospective analysis of transradial (TR) CAS procedures at two centers.
- Evaluation of patient demographics, procedural techniques, outcomes, and complications.
Main Results:
- CAS was successful in 91% of 382 patients undergoing the transradial approach.
- Low rates of adverse events: 0.6% major stroke, 1% minor stroke, no myocardial infarction.
- No bleeding complications, but 6% asymptomatic radial occlusion.
Conclusions:
- The transradial approach is a feasible alternative for CAS.
- It is particularly useful when factors complicate traditional femoral access.
Background:
Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for revascularization of the internal carotid artery (ICA). CAS from the femoral approach may be problematic due to peripheral vascular disease, anatomical variations of the aortic arch, and access site complications. The purpose of this study was to evaluate the right radial approach (RRA) for CAS.
Methods:
A retrospective analysis of all patients who had undergone transradial (TR) CAS at two centers was performed. Demographics, the technique used to deploy the sheath in the common carotid, procedural details, results, and complications were evaluated.
Results:
CAS was attempted from TR in 382 patients (mean age 68, 70% male). CAS was successful in 347/382 (91%) patients; 201/216 (93%) right CA, 14/16 (88%) bovine left CA, 132/150 (88%) left CA. The specific technique varied with the anatomy. Seven different carotid artery stents (51% Xact) and seven different distal embolic protection devices were used. Adverse events included two major strokes (0.6%) one of whom died, three minor strokes (1%), and no myocardial infarction at 30 days. No bleeding complications occurred although 23 (6%) of patients had asymptomatic postprocedure radial occlusion. Inadequate catheter support at the origin of the CCA was the technical cause of failure in the unsuccessful cases which were then completed from femoral access as part of the same procedure.
Conclusion:
The transradial approach is an alternative for CAS in the presence of factors that increase the risk or difficulty of femoral access.
