Article Text

Download PDFPDF

E-138 Safety and feasibility of transradial approach for cervical carotid stenting for treatment of carotid-artery stenosis
  1. E Almallouhi1,
  2. S Al kasab2,
  3. P Jabbour3,
  4. M Gooch4,
  5. A Sweid3,
  6. N Chalouhi4,
  7. S Chen5,
  8. Y Li5,
  9. E Peterson6,
  10. D Yavagal6,
  11. R Starke5,
  12. A Spiotta2
  1. 1Medical University of South Carolina, Charleston, SC
  2. 2Neurosurgery, Medical University of South Carolina, Charleston, SC
  3. 3Neurosurgery, Jefferson University, Philadelphia, PA
  4. 4Jefferson University, Philadelphia, PA
  5. 5Neurosurgery, University of Miami, Miami, FL
  6. 6University of Miami, Miami, FL


Background Traditionally, cervical carotid artery stenting is done through transfemoral or transcarotid approach. However, access site bleeding remains a significant challenge in both techniques, with a rate of about 4% in recent studies. In this study, we explore the feasibility of using transradial approach for cervical carotid stenting as a potential alternative.

Methods We collected data from the prospectively maintained registries of 6 centers in the United States to include consecutive patients who underwent carotid stenting for treatment of symptomatic carotid-artery stenosis using transradial approach from October 2018 until June 2019. Collected data included baseline characteristics, procedural variables, whether there was a crossover to transfemoral access, and complications. Our primary outcome was the complication rate related to the access site.

Results A total of 19 patients were included in this study. Mean age was 68.6 (±8), and 5 (26.3%) were females. The right radial artery access was used in all cases. Stenting of the right cervical internal carotid artery was done in 15 (78.9%) of the cases. Regarding the antispasmodic regimen used, Verapamil was used in 2 cases, Nitroglycerin was used in 6 cases, and a combination of both was used in 11 cases. Between 2000–5000 units of heparin were administered intraarterially or intravenously immediately after obtaining the access. A 6-French sheath was used in 13 cases, a 7-French sheath in 3 cases, and in 3 cases, the guide catheter (AXS Infinity, Stryker, USA) was exchanged over a 7-French sheath. Regarding guide catheters used, Benchmark (Penumbra, USA) was used in 14 cases, AXS Infinity in 3 cases, and Envoy (Codman Neuro, USA) in 2 cases. Mean contrast dose required was 93.3 (±48.4), radiation exposure was 14603 (±26118) mGy, and procedure duration was 24.6 (±14.2) min. None of the included patients had a complication related to access site, and only one patient required a crossover to transfemoral approach because of a device-related complication.

Conclusion Transradial approach is a feasible and safe option for cervical carotid stenting. The complication rate in our study is lower than previously reported numbers for transfemoral and transcarotid carotid stenting, but larger-scale studies are needed to confirm our findings.

Disclosures E. Almallouhi: None. S. Al kasab: None. P. Jabbour: 2; C; Medtronic and MicroVention. M. Gooch: None. A. Sweid: None. N. Chalouhi: None. S. Chen: None. Y. Li: None. E. Peterson: None. D. Yavagal: 2; C; Medtronic Neurovascular, Cerenovus, Rapid Medical and Neuralanalytics. R. Starke: 2; C; Penumbra, Abbott, Medtronic, InNeuroCo and Cerenovus. A. Spiotta: 1; C; Penumbra. 2; C; Penumbra, Stryker, Cerenovus, Terumo.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.