Bicentric clinical study: Feasibility of 088 long sheath in trans-radial carotid artery stenting

Abstract

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.

Keywords: Carotid artery stenosis; Carotid artery stenting; Long sheath; Nerve intervention; Transradial access.