Levy Elad I, Kim Stanley H, Bendok Bernard R, Qureshi Adnan I, Guterman Lee R, Hopkins L Nelson
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Neurosurgery. 2003 Aug;53(2):448-51; discussion 451-2. doi: 10.1227/01.neu.0000073995.81018.2b.
We describe a case of endoluminal stent placement for a cervical internal carotid artery stenosis in which percutaneous access was obtained via the radial artery.
A 69-year-old man with known disease of the carotid, peripheral, and coronary arteries as well as chronic obstructive pulmonary disease presented for endoluminal revascularization of a severe, progressive right internal carotid artery stenosis.
Transfemoral access was complicated by the previous placement of a synthetic graft as the result of a previous right-to-left iliofemoral artery bypass procedure and an aortoiliac occlusion. A transradial approach was successfully attempted, and a Precise stent (Cordis Endovascular, Miami Lakes, FL) was successfully placed through a 6-French guide sheath.
The transradial approach is becoming an increasingly viable alternative route for stent placement in patients with contraindicated or complicated femoral access routes. As devices become increasingly more pliable and smaller, the transradial route will be used with increasing frequency in this select patient population for stenting of both the cervical and intracranial circulation.
