Conflict of interest: Drs. Mann and Sachar receive research support from Abbott Vascular, Boston Scientific, and Cordis. Dr. Kedev has no disclosures.
Peripheral Vascular Disease
The transradial approach for carotid artery stenting†
Article first published online: 20 AUG 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 80, Issue 7, pages 1081–1087, 1 December 2012
How to Cite
Etxegoien, N., Rhyne, D., Kedev, S., Sachar, R. and Mann, T. (2012), The transradial approach for carotid artery stenting. Cathet. Cardiovasc. Intervent., 80: 1081–1087. doi: 10.1002/ccd.24503
- Issue published online: 5 DEC 2012
- Article first published online: 20 AUG 2012
- Accepted manuscript online: 28 MAY 2012 04:33AM EST
- Manuscript Accepted: 20 MAY 2012
- Manuscript Revised: 5 APR 2012
- Manuscript Received: 22 FEB 2012
- Abbott Vascular, Boston Scientific
- complications adult cath/intervention;
- cerebrovascular accident;
- transradial cath;
- cerebrovascular disease
Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for revascularization of the internal carotid artery (ICA). CAS from the femoral approach may be problematic due to peripheral vascular disease, anatomical variations of the aortic arch, and access site complications. The purpose of this study was to evaluate the right radial approach (RRA) for CAS.
A retrospective analysis of all patients who had undergone transradial (TR) CAS at two centers was performed. Demographics, the technique used to deploy the sheath in the common carotid, procedural details, results, and complications were evaluated.
CAS was attempted from TR in 382 patients (mean age 68, 70% male). CAS was successful in 347/382 (91%) patients; 201/216 (93%) right CA, 14/16 (88%) bovine left CA, 132/150 (88%) left CA. The specific technique varied with the anatomy. Seven different carotid artery stents (51% Xact) and seven different distal embolic protection devices were used. Adverse events included two major strokes (0.6%) one of whom died, three minor strokes (1%), and no myocardial infarction at 30 days. No bleeding complications occurred although 23 (6%) of patients had asymptomatic postprocedure radial occlusion. Inadequate catheter support at the origin of the CCA was the technical cause of failure in the unsuccessful cases which were then completed from femoral access as part of the same procedure.
The transradial approach is an alternative for CAS in the presence of factors that increase the risk or difficulty of femoral access. © 2012 Wiley Periodicals, Inc.