P5611Feasibility of distal radial access for carotid interventions: the RADCAR-DISTAL pilot study

Abstract

Abstract Aims The aim of our study was to demonstrate the feasibility and safety of the distal transradial approach (DTRA) for carotid artery stenting (CAS). Methods and results We included 209 consecutive patients (151 Trans-Radial Access (TRA) and 58 DTRA) treated in a single center by CAS with cerebral protection between 2016 and 2018. DTRA punctures were performed by ultrasound guidance, and the carotid artery cannulations were done using a 6.5 F coronary sheathless guiding catheter. The groups showed similar demographic profile regarding age, gender and comorbidities, however the proportion of symptomatic patients was significantly higher in the DTRA cohort (DTRA: 75,86% vs. TRA: 46.36% p<0.001). Procedural success rate was similarly high in both groups, while the overall complication rate was very low, with no major adverse events and only a few vascular complications. The cannulation times were similar, while the overall procedure length was slightly higher in the DTRA group. The cumulative X-ray dose was similarly low regardless the access used. Conclusion DTRA is a safe and effective alternative of conventional trans-radial approach for CAS, with a potential to further improve the patient comfort.