Related Experiment Video
Updated: Mar 20, 2026
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Left transradial carotid artery stenting using the 6-French Simmons guiding sheath: Initial experiences with three
Taigen Sase1, Hidemichi Ito1, Toshihiro Ueda1
1Departments of Neuroendovascular Therapy, St. Marianna University School of Medicine, Kanagawa, Japan; Departments of Neurosurgery, St. Marianna University School of Medicine, Kanagawa, Japan.
Background:
The transradial approach (TRA) has been increasingly adopted in the neurointervention field owing to its advantages, including fewer puncture site complications and earlier ambulation. Although the right radial artery is conventionally used, the left TRA demonstrates clinical advantages in coronary intervention. However, the number of reports on the neurointervention using the left TRA remains limited, and its clinical utility has not been clearly established. We evaluated the efficacy of the left TRA in carotid artery stenting (CAS) using a Simmons guiding sheath (SGS).
Materials And Methods:
We retrospectively examined a prospective database of consecutive patients who underwent left TRA-CAS with a 6-French SGS between March 2022 and August 2025 at our institution. SGSs were formed within the aortic arch, using three novel techniques that we developed in this study. Subsequent outcome measures, including catheterization success, procedural outcomes, and procedure-related complications, were evaluated.
Results:
Overall, 63 patients (31 right and 34 left carotid artery stenoses) underwent left TRA-CAS. The SGS was successfully formed and inserted into the intended common carotid artery in 63/65 (96.9%) procedures. In two cases, crossover was necessary because of significant radial artery spasm. All patients were successfully treated with favorable carotid lumen dilatation; none experienced major adverse events or radial artery occlusion.
Conclusion:
Left TRA-CAS using the 6-French SGS was successfully performed with a high success rate and without serious complications, suggesting its effectiveness and safety.
