Initial Experience of a Novel Sheath Guide Specifically Designed for Transradial Approach for Carotid Artery Stenting

Abstract

The transfemoral approach is a common technique for carotid artery stenting (CAS) but is sometimes limited by aortic or peripheral arterial conditions. The purpose of this study is to report the initial experiences with CAS using a novel sheath guide for transradial carotid cannulation. A sheath guide designed specifically for transradial carotid cannulation was developed. The transradial approach for CAS was started in April 2016, and data were collected prospectively. Patients who underwent transradial elective CAS from April 2016 to June 2018 were included in the analysis. Every CAS procedure was started through the right radial route with a 6-French (internal diameter) sheath guide specifically designed for the radial approach under local anesthesia. Technical success, periprocedural complications, and 30-day major vascular events (stroke, myocardial infarction, and/or death) were investigated. Twenty-six patients underwent transradial CAS. Procedures performed via the radial route were successful in every case. A periprocedural complication (transient ischemic attack after CAS) occurred in 1 patient. The patient returned to the preoperative state within a few days and had no neurologic deficits. No access site-related complications occurred. Patients who underwent transradial CAS could walk immediately after CAS, even during hemostasis. No major cardiovascular events occurred within 30 days after CAS. The herein-described sheath guide specifically designed for transradial carotid cannulation was useful for CAS.