Skin to Skin: Transradial Carotid Angiography and Stenting

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• Carotid artery stenting (CAS) is an established treatment for significant carotid artery disease.
• The transfemoral approach (TFA) is the standard access route for CAS.
• TFA can be limited by peripheral vascular disease, anatomical variations, and complex aortic arches, leading to access site complications and technical failures.

Purpose of the Study:

• To evaluate the transradial approach (TRA) as an alternative access site for CAS.
• To determine if TRA can overcome the limitations associated with TFA, particularly in cases with complex aortic anatomy.

Main Methods:

• Review of existing literature and case studies comparing TFA and TRA for CAS.
• Analysis of complication rates and technical success related to access site and aortic arch complexity.
• Evaluation of patient factors influencing the choice of access site.

Main Results:

• Access site complications are the most frequent adverse events with TFA.
• Complex aortic arch anatomy poses significant challenges for TFA, impacting technical success.
• The transradial approach has demonstrated potential as a feasible alternative, particularly in challenging anatomies.

Conclusions:

• The transradial approach may be a valuable strategy to mitigate TFA-related complications in CAS.
• TRA offers a promising alternative for patients with complex aortic arches undergoing carotid revascularization.
• Further research is warranted to fully establish the role of TRA in CAS procedures.