Safety and feasibility of sheathless TRA-CAS
limitation of transradial approach(TRA) carotid artery stenting (CAS) is the inability to use large guiding catheters (7Fr.) when radial artery size
limitation of transradial approach(TRA) carotid artery stenting (CAS) is the inability to use large guiding catheters (7Fr.) when radial artery size is too small. The purpose of our study was to evaluate the feasibility and safety of sheathless TRA CAS comparing with transbrachial approach (TBA) when radial artery size is too small.
33 patients with CAS and small radial artery size were selected for CAS via sheathless TRA comparing with 61patients underwent CAS using TBA. Usual radial artery puncture accommodating a 5Fr. arterial sheathand 7Fr. guiding catheter was used for diagnostic cerebral angiography and subsequent CAS. Routine assessments of radial artery pulsation via color Doppler ultrasound or clinical follow up were done at 1 and 6 month after procedure. There were no baseline characteristics differences between TRA and TBA. There were no major complications nor radial access site complications, as compared with TBA CAS, stroke occurred in 3/61, and 2 brachial pseudo-aneurysm demanding surgical repair. Significant longer hospital stay in TBA than sheathless TRA in this study(10.9 ± 8.4 vs. 8.3 ± 5.5, P=0.042). Allradial arteries were patent during 1 and6 month follow up. The results showed sheathless TRA CAS in patients with severe carotid artery stenosis and small radial artery size is safe and technically feasible with lower major complications, significant shorter hospital stay and good clinical radial artery patency.
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