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Updated: Jul 11, 2025
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Published on: September 20, 2020
Carotid Artery Stenting via Radial Access with Modified Flow Reversal Method: Case Series
Shunsuke Tanoue1, Kenichiro Ono2, Terushige Toyooka3
1Department of Neurosurgery, Mishuku Hospital, Tokyo, Japan; Department of Neurosurgery, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan.
Objective:
Neuroendovascular treatment via transradial access (TRA) has gained popularity as a minimally invasive technique. However, the flow reversal (FR) system, reported useful in carotid artery stenting (CAS), cannot be applied via TRA because it requires an access route of more than 8 F. Herein, we report the utility of a modified FR system applied via TRA using a sheathless 8-F balloon guide catheter and a 2.6-F balloon catheter.
Methods:
In a retrospective analysis of a single-center consecutive case series, patients with CAS and vulnerable plaques who were treated with CAS via TRA using a modified FR system from June 2022 to August 2022 were examined. High-intensity spots were assessed on postprocedural diffusion-weighted magnetic resonance images. Puncture site complications at discharge and cardiovascular events for 1 year after CAS were also evaluated.
Results:
Ten patients were included in this study. There were no high-intensity spots on diffusion-weighted magnetic resonance images after CAS. No procedure-related complications, including radial artery occlusion or cardiovascular events, were observed.
Conclusions:
This study suggests that CAS with FR using our modified system is feasible via TRA and may be an effective technique with a low rate of vascular complications.
