Backgrounds and Purpose
Transfemoral approach for carotid artery stenting (CAS) is a common technique, but patients must be bedridden for several hours following CAS. If CAS can be performed through the brachial artery route, it is less invasive for patients. The purpose of our study was to investigate the feasibility, efficacy and safety of transbrachial approach for CAS.
Materials and Methods
Transbrachial approach for CAS was started at October 2010 and data was collected prospectively. Included for analysis were patients who underwent transbrachial elective CAS from October 2010 to July 2011. Every CAS was started through the right brachial route with a 6Fr (ID) guiding sheath specifically designed for the brachial approach under local anesthesia. Technical success, periprocedural complications, 30-day major cardiovascular events (stroke, myocardial infarction and death) and 3- month stent restenosis were investigated.
Results
Forty-five patients underwent transbrachial CAS. Procedures were successful through the brachial route in every case. Periprocedural complications occurred in three cases; confusion following CAS in one case, hypotension in one case and gastrointestinal hemorrhage in one case. Three patients returned to the previous state within a few days and had no neurological deficits. No access-site related complications occurred. Patients were free on the bed immediately after CAS even during hemostasis. Neither 30- day major cardiovascular events nor 3-month stent restenosis occurred.
Conclusions
Transbrachial CAS is feasible and safe, and has the same efficacy as transfemoral CAS.
Efficacy and safety of carotid artery stenting for stroke prevention
