Transbrachial carotid artery stenting can prevent renal cholesterol embolism

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Nephrology

Background:

• Internal carotid artery stenosis poses a significant risk of stroke.
• Previous percutaneous interventions in this patient were complicated by renal cholesterol embolism.
• The patient presented with left internal carotid artery occlusion and progressive right internal carotid artery stenosis.

Observation:

• Successful stenting of the right internal carotid artery was achieved using a right brachial artery approach.
• No instances of cholesterol embolism were observed post-procedure.
• The patient's history of renal cholesterol embolism was a key consideration in procedural planning.

Findings:

• Carotid artery stenting (CAS) via the brachial approach appears to be associated with a lower incidence of cholesterol embolism.
• This approach may offer an alternative to the femoral approach in patients with a history of embolic events.

Implications:

• The brachial approach for CAS could be a safer alternative for patients susceptible to cholesterol embolism.
• Further studies are warranted to confirm the reduced embolic risk of the brachial approach in carotid artery stenting.
• This case contributes to understanding procedural risks and optimizing patient selection for carotid revascularization.