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Transradial approach for vertebral artery stenting.
Damian Maciejewski1, Łukasz Tekieli1, Anna Kabłak-Ziembicka1
1Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Summary
Transradial stenting for vertebral artery stenosis is safe and effective, offering symptom relief in most patients. This approach provides an alternative to traditional femoral access, especially for those with peripheral artery disease.
Area of Science:
- Cardiovascular Interventions
- Neurology
- Vascular Surgery
Background:
- Symptomatic severe vertebral artery (VA) stenosis can lead to posterior circulation ischemia.
- Femoral access for VA stenting is established, but data on transradial approach, particularly in patients with peripheral artery disease (PAD), is limited.
Purpose of the Study:
- To evaluate the safety and efficacy of the transradial approach for angioplasty and stenting in patients with symptomatic VA stenosis.
Main Methods:
- A prospective study involving 15 patients with symptomatic severe VA stenosis and PAD or failed femoral access.
- Transradial VA angioplasty with stent placement was performed.
- Clinical and duplex ultrasound follow-up was conducted at 1, 12, and 24 months post-procedure.
Main Results:
- 100% technical success rate with significant reduction in VA stenosis (85.3% to 5.3%).
- No periprocedural stroke, myocardial infarction, or death.
- Symptom relief observed in 12 of 15 patients within 24 months; one borderline in-stent stenosis occurred.
Conclusions:
- Transradial VA stenting is a safe and highly effective procedure.
- It serves as a viable alternative to the femoral approach for treating symptomatic VA stenosis, especially in patients with PAD.
