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SNIS 20th annual meeting electronic poster abstracts
E-212 A comparison of outcomes between transfemoral versus transradial access for carotid stenting
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  1. K El Naamani,
  2. O Khanna,
  3. A Syal,
  4. A Momin,
  5. R Abbas,
  6. A Amllay,
  7. A Sambangi,
  8. A Hunt,
  9. J Dougherty,
  10. C Lawall,
  11. S Tjoumakaris,
  12. M Gooch,
  13. N Herial,
  14. R Rosenwasser,
  15. H Zarzour,
  16. R Schmidt,
  17. P Jabbour
  1. Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA

Abstract

Background The transradial (TR) approach has emerged as an alternative to the transfemoral (TR) approach in carotid artery stenting (CAS) due to its perceived benefits in access site complications and overall patient experience.

Objective To assess outcomes of transfemoral vs transradial approach for carotid artery stenting.

Methods This is a retrospective single-center review of patients receiving CAS via the TR or TF route between 2017 and 2022. All patients with symptomatic and asymptomatic carotid disease who underwent attempted CAS were included in our study.

Results A total of 342 patients are included in the study: 232 underwent CAS via TF approach vs 110 via the TR route. On univariate analysis, the rate of overall complications was more than double for the TF vs TR cohort, however this did not achieve statistical significance (6.5%vs2.7%, OR=0.59 p=.36). The rate of cross-over from TR to TF was significantly higher on univariate analysis (14.6%vs2.6%, OR=4.77, p=.005) and on inverse probability treatment weighting analysis (OR= 6.11, p<.001). The rate of in-stent stenosis (TR:3.6% vs TF:2.2%, OR=1.71, p=.43) and strokes at follow-up (TF:2.2% vs TR:1.8%, OR= 0.84, p=.84) was not significantly different. Lastly, median length of stay was comparable between both cohorts.

Conclusion The TR approach is safe, feasible, and provides similar rates of complications and high rates of successful stent deployment compared with the TF route. Neurointerventionalists adopting the radial first approach should carefully assess the pre-procedural computed tomography angiography to identify patients amenable to TR approach for carotid stenting.

View this table:
Abstract E-212 Table 2

Comparison of outcomes between trans-radial vs trans-femoral access

Disclosures K. El Naamani: None. O. Khanna: None. A. Syal: None. A. Momin: None. R. Abbas: None. A. Amllay: None. A. Sambangi: None. A. Hunt: None. J. Dougherty: None. C. Lawall: None. S. Tjoumakaris: 2; C; Microvention, Medtronic. M. Gooch: 2; C; Stryker. N. Herial: None. R. Rosenwasser: None. H. Zarzour: None. R. Schmidt: None. P. Jabbour: 2; C; Microvention, Medtronic, Balt, Ceres Endovascular.

https://doi.org/10.1136/jnis-2023-SNIS.311

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