Transradial approach for carotid artery stenting in a patient with severe peripheral arterial disease

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Internal carotid artery stenosis is a significant risk factor for ischemic stroke.
• Peripheral artery disease often coexists with cerebrovascular disease, complicating treatment decisions.
• Transradial access offers potential advantages in specific patient populations.

Purpose of the Study:

• To report a successful case of right internal carotid artery stenting (RICA-CAS) in a patient with critical bilateral stenosis.
• To highlight the feasibility of a transradial approach in complex vascular interventions.
• To discuss the management of combined cerebrovascular and peripheral artery disease.

Main Methods:

• A 73-year-old male patient with critical bilateral internal carotid artery stenosis, recent right-hemisphere stroke, and severe peripheral artery disease was selected.
• Right internal carotid artery stenting (RICA-CAS) was performed.
• A right transradial approach was utilized for the intervention.

Main Results:

• The right internal carotid artery stenting (RICA-CAS) procedure was technically successful.
• The transradial approach was feasible and well-tolerated in this complex case.
• The patient's comorbidities, including stroke and peripheral artery disease, did not preclude successful stenting.

Conclusions:

• Transradial access can be a viable option for internal carotid artery stenting (CAS) in select patients with complex vascular disease.
• Successful RICA-CAS via a transradial approach in this case demonstrates its potential utility.
• Multivessel revascularization strategies should be considered in patients with combined cerebrovascular and peripheral artery disease.