The feasibility and efficacy of transradial approach for carotid artery stenting using 6 F guiding catheter / 中华放射学杂志

ABSTRACT

Objective To explore the feasibility and safety of using 6 F guiding catheter to perform the carotid artery stenting (CAS) via transradial approach (TRA). Methods A retrospective analysis of 28 cases with carotid atherosclerotic stenosis who were using 6 F guiding catheter to perform the CAS via TRA, and the preoperative assessment confirmed that some of whom were difficult to operate via femoral artery, or couldn't tolerate the lying in bed after the operation, and the others were failure to perform via femoral artery. The atherosclerotic carotid stenosis lesion of 9 cases were located in the left internal carotid artery (ICA), and the other 19 cases were in the right ICA. All the patients were performed via the right radial artery approach, a 6 F guiding catheter was used to super-select the target vessel, implanted the distal protection device, then underwent balloon angioplasty and stent implantation. We observed and recorded that whether the guiding catheters were in the right places, the success rate of stent implantation, the incidence of radial artery spasm and the puncture site bleeding. The postoperative pulse and occlusion of radial artery, and the occurrence of cardio-cerebrovascular complications during perioperative period were also observed. The fluoroscopy time of surgery ray were also recorded, and compared with corresponding 30 cases who were performed CAS via the tranfemoral approach (TFA) by t test. Results The guiding catheters were in the right places and stenting success of all the 28 cases. There was no significant difference in the fluoroscopy time between TRA and TFA group [(8.6 ± 1.4) min vs. (9.0 ± 2.1) min,t=-0.717,P=0.477)]. Two cases appeared radial artery spasm after puncture, and 1 case experienced puncture site bleeding at 8 h after the operation. After examined the radial artery by color doppler ultrasound at 1 week after the operation, we found that blood flow of 27 cases were patency, but another 1 was slowed down, which was restored at 3 months follow up. None of the cases occurred cerebrovascular events in the present research. Conclusion Transradial approach for CAS using 6 F guiding catheter is safe and technically feasible.