P5.18 TRANSRADIAL APPROACH FOR VERTEBRAL ARTERY STENTING: SINGLE-CENTER EXPERIENCE

Abstract

Objectives: Transradial vertebral artery (VA) angioplasty might be a viable alternative to the transfemoral approach in cases of peripheral artery disease or anatomical variations of the aortic arch. The purpose of our study was to evaluate the safety and efficacy of transradial stenting of symptomatic VA stenosis. Material and methods: Seventeen patients [67±8,4 years, 76% men, with >80% stenosis, 13 right-side, all symptomatic from posterior circulation (history of stroke, TIA or chronic ischemic symptoms)] with peripheral artery disease (PAD) or unsuccessful attempt via femoral access were scheduled for VA angioplasty by radial approach. Clinical and duplex ultrasound (DUS) follow-up were performed before discharge and 6, 12 and 24 months after VA stenting. Results: The technical success rate was 100%. In all cases VA angioplasty was performed with the use of single balloon-mounted stent (11 bare metal stents, 6 drug eluting stents). The mean NASCET VA stenosis was reduced from 87,5% to 5,9% (p<0.001). No periprocedural death, stroke, myocardial infarction or transient ischemic attack occurred. During 24-months follow-up in 14 of 17 patients chronic ischemia symptoms release was observed, no new acute ischemic neurological symptoms were diagnosed in all patients. One patient died 20 months after intervention from unknown cause. There was one, symptomatic border-line VA in-stent stenosis 12 months after angioplasty. Conclusion: Transradial VA stenting may be effective and safe procedure and it may constitute an alternative to femoral approach in patients with symptomatic vertebral artery stenosis.