Brachial Artery Access for Carotid Artery Stenting: A Pooled Analysis

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurosurgery

Background:

• Carotid artery stenting (CAS) is a crucial procedure for stroke prevention.
• Transbrachial access (TBA) offers an alternative route for CAS.
• Evaluating TBA's safety and efficacy is essential for clinical decision-making.

Purpose of the Study:

• To systematically review and meta-analyze the safety and efficacy of transbrachial access (TBA) in carotid artery stenting (CAS).
• To assess key outcomes including neurological results, procedural success, and complication rates associated with TBA for CAS.

Main Methods:

• A comprehensive literature search was conducted across Medline, Cochrane Library, Embase, and Web of Science.
• Included studies reported on TBA for CAS with outcomes on neurological status, procedural success, and complications.
• Studies with fewer than 4 patients were excluded, and 11 studies involving 273 patients were analyzed.

Main Results:

• A procedural success rate of 100% (95% CI: 98% to 100%) was observed across nine studies.
• Good neurological outcomes were achieved in 99% (95% CI: 98% to 100%) of patients in eight studies.
• A low complication rate of 1% (95% CI: 0% to 9%) and 0% mortality (95% CI: 0% to 1%) were reported.

Conclusions:

• Transbrachial access (TBA) for carotid artery stenting (CAS) is a highly effective and safe procedure.
• TBA can be considered a valuable option for patients lacking alternative vascular access.
• Further comparative studies are warranted to solidify the role of TBA in CAS.