Background: Carotid artery stenting (CAS) using the femoral approach can be a problematic due to access site complications, PVD or anatomical variations of the aortic arch.
Aim: Describing our experience of CAS by using the right radial approach (RRA).
Material & Methods: Fifteen patients (pts); mean age 58+ 7, 13 male underwent CAS. All had CA stenosis > 70%, 9/15(60%) were asymptomatic. Eleven pts had right and 4 had left internal CA stenosis (3 Bovine and 1 normal aortic arch)
Technique: The target common carotid artery was initially cannulated by using 5F either right, left Judkins, IMA or Simmons-1 diagnostic catheters. These catheters were advance towards peripheral branches of the External CA system using Terumo 0.035" wire. Through the diagnostic catheters a 0.035 Extra stiff exchange wire was navigated to the External CA . Over this wire a 6F shuttle sheath was advanced to the distal common CA whereas the procedure was completed by the standard technique. All sheaths were removed immediately post procedure.
Results: CAS was successfully completed in 13/15 (87 %) pts including 10/15 with the right and 3/4 with the left CA stenosis. The single cause of technical failure was inadequate catheter support at the origin of the common CA. Mean procedure time was 35+ 7 minutes. No port of access neither neurological complications were recorded. Mean hospital stay was 1+ 2 days due to symptomatic bradycardia.
Conclusions: CAS using the RRA seems to be safe and technically feasible. This approach may be particularly useful for patients with right CA stenosis, Bovine artic arch and severe PVD.
