Department of Neurology, Tokai University, Isehara, Japan.
World Neurosurg. 2019 Oct;130:e760-e764. doi: 10.1016/j.wneu.2019.06.215. Epub 2019 Jul 5.
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.
股动脉入路是颈动脉支架置入术（CAS）的常用技术，但有时会受到主动脉或外周动脉条件的限制。本研究旨在报告使用新型经桡动脉入路颈动脉插管鞘管导引导管进行 CAS 的初步经验。
专门设计了一种用于经桡动脉颈动脉插管的鞘管导引导管。从 2016 年 4 月开始采用经桡动脉入路进行 CAS，并前瞻性收集数据。分析了 2016 年 4 月至 2018 年 6 月期间接受经桡动脉择期 CAS 的患者。每例 CAS 手术均在局部麻醉下通过右桡动脉途径开始，使用专门设计用于桡动脉入路的 6F（内径）鞘管导引导管。研究了技术成功率、围手术期并发症和 30 天主要血管事件（卒中和/或死亡）。
26 例患者接受了经桡动脉 CAS。所有病例均通过桡动脉途径成功完成了手术。1 例患者在 CAS 后出现短暂性脑缺血发作。患者在几天内恢复到术前状态，无神经功能缺损。无血管入路相关并发症发生。行经桡动脉 CAS 的患者在 CAS 后可立即行走，甚至在止血期间也可行走。CAS 后 30 天内无重大心血管事件发生。
专门设计用于经桡动脉颈动脉插管的鞘管导引导管在 CAS 中非常有用。
