P5.19 TRANSRADIAL APPROACH FOR CAROTID ARTERY STENTING: SINGLE-CENTER EXPERIENCE

Abstract

Objectives: The transfemoral approach is commonly used for carotid artery stenting (CAS) however in cases of severe peripheral vascular disease or unfavorable aortic arch anatomy, the transradial access remains a viable alternative. We report a series of patients with aorto-iliac disease or unsuccessful attempt via femoral access in whom transradial carotid artery stenting was performed. Material and methods: Sixteen patients (69±10,7 years, 75%men, with >70% stenosis, 10 left-side, 5 contralateral carotid occlusion, 9 with history of stroke or TIA) with peripheral artery disease (PAD) or unsuccessful attempt via femoral access were scheduled for carotid artery angioplasty by radial approach. Clinical and duplex ultrasound (DUS) follow-up were performed before discharge and 1, 12 and 24 months after carotid artery stenting. Results: The technical success rate was 87,5%. In two cases attempt via femoral and radial access were unsuccessful and the patients were treated by endarterectomy. In other cases CAS was performed with self-expanding bare metal stents. The mean NASCET carotid artery stenosis was reduced from 85% to 9,6% (p<0.001). No periprocedural death, stroke, myocardial infarction or transient ischemic attack occurred. During 24-months follow-up no new acute ischemic neurological symptoms were diagnosed in all patients. One patient died 2 months after intervention due to deterioration of chronic obstructive pulmonary disease. Conclusion: Transradial carotid artery stenting may be safe and useful alternative when femoral approach is difficult or impossible.