Carotid Artery Stent Placement via Radial Arterial Route

Objective: To report our experience in performance of carotid artery stent placement via radial arterial route and compare with femoral arterial route. Background: Carotid artery stent placement via the femoral arterial route has emerged as an acceptable method for treating symptomatic and asymptomatic internal carotid artery stenoses. Radial arterial route may be used as an alternate route for performing carotid artery stent placement. Design/Methods: We ascertained the rates of technical success and cross over and compared procedure times and use of analgesics during procedure between the two routes. We also ascertained any adverse events associated with the procedure. Results: A total of 9 of 67 carotid artery stent procedures were performed via the radial arterial route. Cross over to femoral arterial route was necessary in 3 patients with initial radial artery route attempt due to anatomical tortuosity (n=1), patient discomfort (n=1) and kinking of the sheath (n=1). The femoral arterial route attempt required to cross over to radial arterial route in two patients due to anatomical tortuosity. The mean procedure time (in minutes) was similar between the two arterial routes (36.8 for radial and 38.9 for femoral route). The mean dose of intravenous fentanyl (82.4 mcg versus 89.7 mcg) and midazolam (1.35 mg versus 1.3 mg) was similar between the two arterial routes. Periprocedural complications occurred in one patient (groin hematoma) who underwent carotid artery stent placement via femoral arterial route compared to none via radial arterial route. Conclusions: Carotid artery stent placement via radial arterial route is feasible and comparable to procedures performed via femoral arterial route. Disclosure: Dr. Balasetti has nothing to disclose. Dr. Akhtar has nothing to disclose. Dr. Kumar has nothing to disclose. Dr. Siddiq has nothing to disclose. Dr. Gomez has nothing to disclose. Dr. Qureshi has nothing to disclose.