Transradial Approach For Carotid Artery Intervention

Background:Carotid artery angiography is the gold stardard of diagnosis of carotid artery stenosis. Carotid artery stenting (CAS) has become accepted as an alternative to carotid endarterectomy for revascularization of the internal carotid artery (ICA) among high risk patients. Trans-radial approach has become a conventional access in percutaneous coronary interventional (PCI) procedures. Carotid stenosis often associate with CAD, CAS can be accomplished with PCI at the same intervention procedure in these patients. Objective:To evaluate the feasibility and safty of transradial approach for carotid intervention. Methods:42patients had a CA stenosis greater than70%and comorbid conditions increasing the risk of carotid endarterectomy.12patients were selected to undergo carotid artery stenting from the radial approach. After removing the diagnostic catheter and the transradial sheath, a7.5F sheathless guiding catheter was passed over the guide wire to aortic arch, manipulate the GC into the target common carotid. CAS was performed using standard techniques. Results:CAS was successful in all12patients, including6/12right CA,6/12left CA. Mean interventional time was45+11minutes. There were no radial access site complications. One patient had TIA last2hours,2patient had transient Bradycardial and hypotension after stent deployment. Conclusion:Carotid intervention by using the trans-radial approach appears to be safe and technically feasible. Refinement of the technique and the improvement of endovascular device may lead to replacement of the conventional femoral access by the trans-radial route in the near future.