Abstract
Objective: To evaluate the feasibility and safety of carotid artery stenting (CAS) via the transradial approach (TR-CAS).
Materials and Methods: Among the 157 CAS patients (180 lesions) treated at our department from 2005 to 2011, a total of 6 patients underwent TR-CAS. We evaluated the technical success and periprocedural and access-site complications of this procedure retrospectively. First, we inserted a 4 Fr sheath into the right radial artery, then infused spasmolytic agents, and replaced the 4 Fr sheath with a 6 Fr guide sheath.
Results: The reasons to use the transradial approach were "bovine" arch (the left carotid artery originating in the brachiocephalic trunk) in 2 patients, abdominal aortic aneurysm in 3 patients (fusiform or dissecting), and bilateral femoral vascular prostheses in 1 patient, respectively. In both of the cases of "bovine" arch, it was relatively easy to place the tip of the guide sheath into the common carotid artery on the affected side. Conversely, in the other 4 cases, stiff or extra-stiff guidewires were needed to place the tip of the guide sheath appropriately. TR-CAS was successfully performed in 5 cases (83%) without any complications. In a case with right carotid stenosis, TR-CAS could not be performed and resulted in a periprocedural stroke. There were no access-site complications in any of these cases.
Conclusion: TR-CAS appears to be a useful alternative to CAS candidates that are unsuitable for the transfemoral approach.
