Carotid Artery Stenting Using Sheathless 8Fr Optimo Balloon Guide Catheter System via Transradial Access.

BACKGROUND

The transradial approach (TRA) is a less invasive alternative for carotid artery stenting (CAS). However, limited device availability has restricted its application, and reports on balloon guide catheters (BGCs) in TRA are scarce. This study reports the initial experience with sheathless 8Fr BGC in CAS via TRA.

METHODS

We retrospectively analyzed cases of CAS performed with a sheathless 8Fr Optimo BGC (Tokai Medical Products, Aichi, Japan) via TRA from April 2023 to November 2024. Patient demographics, procedural details, and outcomes were evaluated. The primary efficacy endpoint was the technical success rate, while the primary safety endpoint was a composite of major access-related complications, stroke, myocardial infarction, and death within 30 days.

RESULTS

A total of 30 cases were included (median age 77 years; 90% male). Symptomatic lesions were present in 42%, with a median stenosis rate of 79%, and 63% involved the right carotid artery. Sheathless BGC insertion and navigation succeeded in 29 cases (97%), with 1 case (3%) requiring conversion to brachial access due to radial artery spasm. Balloon inflation for flow control and device stabilization was performed in 23 cases (77%). CAS was successful in all cases, with no major complications or adverse events.

CONCLUSION

Our experience suggests that the sheathless 8Fr BGC is safe and feasible for CAS via TRA. This approach preserves the minimally invasive nature of TRA while improving device stability and potentially reducing embolic risk. Further development of TRA-specific low-profile devices may enhance procedural outcomes and broaden adoption in neurointervention.