Cao Wei, Jiang Zheng, Tang Si Zhao, Zuo Qiao, Zhu Deyuan, Qi Dayong, Ye Shifei, Li Qiang, Zhao Rui, Huang Qinghai, Liu Jianmin, Fang Yibin
Department of Neurovascular Disease, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Neurology, Fuzhou Second General Hospital, Fuzhou, 350007, China.
Neurosurg Rev. 2025 May 13;48(1):413. doi: 10.1007/s10143-025-03539-5.
This study evaluates the feasibility and safety profile of carotid artery stenting (CAS) via transradial access (TRA) using a 0.088-inch-diameter ('088') long sheath, providing an alternative to the conventional transfemoral approach in patients with carotid artery stenosis. A retrospective review of 16 consecutive patients who underwent CAS via TRA at two neurointerventional centres from 2021 to 2022 was conducted. The primary outcome was technical success, defined as residual stenosis of less than 30% without major perioperative complications. Secondary outcomes included stroke, myocardial infarction, and radial artery occlusion within 30 days post-procedure. All procedures achieved technical success. One patient experienced a transient ischemic attack (TIA) intraoperatively that resolved without sequelae. No major disabling stroke, myocardial infarction, or radial artery occlusion occurred during 30-day follow-up. The mean post-operative residual stenosis was 10.8% ± 6.4%. Most patients (87.5%) were treated with a distal protection device, and none required conversion to transfemoral access. Although limited by sample size and lack of long-term follow-up, this study suggests that CAS via TRA using an 088 long sheath is a feasible and safe alternative in selected patients, particularly those with challenging vascular anatomy.
本研究评估了使用0.088英寸直径（“088”）长鞘经桡动脉途径（TRA）进行颈动脉支架置入术（CAS）的可行性和安全性，为颈动脉狭窄患者提供了一种替代传统经股动脉途径的方法。对2021年至2022年在两个神经介入中心接受经桡动脉途径CAS的16例连续患者进行了回顾性研究。主要结局为技术成功，定义为残余狭窄小于30%且无围手术期重大并发症。次要结局包括术后30天内的卒中、心肌梗死和桡动脉闭塞。所有手术均取得技术成功。1例患者术中发生短暂性脑缺血发作（TIA），未遗留后遗症。在30天随访期间未发生重大致残性卒中、心肌梗死或桡动脉闭塞。术后平均残余狭窄为10.8%±6.4%。大多数患者（87.5%）使用了远端保护装置，无一例需要转为经股动脉途径。尽管受样本量和缺乏长期随访的限制，但本研究表明，使用088长鞘经桡动脉途径进行CAS在选定患者中是一种可行且安全的替代方法，尤其是那些血管解剖结构复杂的患者。
