Transradial Carotid Intervention: Technology on the Rise, Single-center Retrospective Review

This study aimed to compare the early results of transradial carotid angioplasty and stent placement (TR-CAS) to transfemoral carotid artery angioplasty and stent placement (TF-CAS) in both asymptomatic and symptomatic patients from 2020 to 2023. During the review period, 137 patients underwent carotid angioplasty with stent placement with embolic protection (CAS) percutaneously, 92 undergoing trans femoral TF-CAS and 45 patients undergoing TR-CAS. There were significantly more symptomatic patients in the TF-CAS group vs the TR-CAS. The results showed that both procedures had similar technical success rates and procedural times. However, patients who underwent TR-CAS had significantly lower rates of access site complications compared with those who underwent TF-CAS. There were four strokes, three transient ischemic attacks, and one death in the TF-CAS cohort and one transient ischemic attack and one stroke and one NSTEMI in the TR-CAS cohort, consistent with the presence of significantly more symptomatic patients in the TF-CAS group. These findings suggest that TR-CAS is a safe and effective alternative to TF-CAS for the treatment of carotid artery stenosis, with the added benefits of reduced access site complications, and possibly lower costs. Further investigation with prospective randomization would need to performed to confirm these preliminary findings.