Carotid Artery Stenting Using Five-French Distal Radial Vascular Access
Carotid artery stenting (CAS) is usually performed through a femoral vascular access using 6–9 Fr guiding catheters. We investigated whether a systematic distal radial approach using 5 Fr guiding sheaths was a safe and effective alternative to transfemoral approach for CAS. From July 2020 to October...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/7/1266 |
| _version_ | 1797608154902560768 |
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| author | Giuseppe Di Gioia Luigi Salemme Marco Ferrone Angelo Cioppa Grigore Popusoi Armando Pucciarelli Sebastiano Verdoliva Michele Franzese Simion Marga Emanuele Barbato Tullio Tesorio |
| author_facet | Giuseppe Di Gioia Luigi Salemme Marco Ferrone Angelo Cioppa Grigore Popusoi Armando Pucciarelli Sebastiano Verdoliva Michele Franzese Simion Marga Emanuele Barbato Tullio Tesorio |
| author_sort | Giuseppe Di Gioia |
| collection | DOAJ |
| description | Carotid artery stenting (CAS) is usually performed through a femoral vascular access using 6–9 Fr guiding catheters. We investigated whether a systematic distal radial approach using 5 Fr guiding sheaths was a safe and effective alternative to transfemoral approach for CAS. From July 2020 to October 2022, two operators at our center systematically performed CAS using a 5 Fr distal radial approach in consecutive patients. The main endpoints of the study were procedural success via distal radial and via proximal or distal radial access. The learning curve was evaluated by comparing the first half of patients versus the second half of patients enrolled. Procedural data and 30-day clinical outcomes were collected. Fifty-one patients were prospectively enrolled. CAS was effectively performed via distal radial access in 45 patients (88%). Overall radial artery success was 92%. Distal radial CAS was successfully performed in 20 out of the first 25 patients enrolled (80%), and in 25 of the last 26 patients enrolled (96%; <i>p</i> = 0.07). Significantly less contrast was administered in the last 26 patients compared to the first 25 enrolled (110 (70, 140) mL vs. 120 (107, 150) mL; <i>p</i> = 0.045). Radial artery occlusion was reported in 1 patient (2%). Only 1 minor stroke (2%) was reported in-hospital and at 30-day follow-up. In conclusion, distal radial CAS using 5 Fr catheters was a safe procedure with a high success rate. The procedure had a relatively short learning curve in operators familiar with transfemoral CAS. |
| first_indexed | 2024-03-11T05:39:31Z |
| format | Article |
| id | doaj.art-123e375674e24d7ea9211a0b3e7dcc48 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T05:39:31Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-123e375674e24d7ea9211a0b3e7dcc482023-11-17T16:30:09ZengMDPI AGDiagnostics2075-44182023-03-01137126610.3390/diagnostics13071266Carotid Artery Stenting Using Five-French Distal Radial Vascular AccessGiuseppe Di Gioia0Luigi Salemme1Marco Ferrone2Angelo Cioppa3Grigore Popusoi4Armando Pucciarelli5Sebastiano Verdoliva6Michele Franzese7Simion Marga8Emanuele Barbato9Tullio Tesorio10Catheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyDepartment of Radiology, Nicolae Testemitanu State University of Medicine and Pharmacy, MD-2000 Chișinău, MoldovaDepartment of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, ItalyCatheterization Laboratory, Montevergine Clinic, 83013 Mercogliano, ItalyCarotid artery stenting (CAS) is usually performed through a femoral vascular access using 6–9 Fr guiding catheters. We investigated whether a systematic distal radial approach using 5 Fr guiding sheaths was a safe and effective alternative to transfemoral approach for CAS. From July 2020 to October 2022, two operators at our center systematically performed CAS using a 5 Fr distal radial approach in consecutive patients. The main endpoints of the study were procedural success via distal radial and via proximal or distal radial access. The learning curve was evaluated by comparing the first half of patients versus the second half of patients enrolled. Procedural data and 30-day clinical outcomes were collected. Fifty-one patients were prospectively enrolled. CAS was effectively performed via distal radial access in 45 patients (88%). Overall radial artery success was 92%. Distal radial CAS was successfully performed in 20 out of the first 25 patients enrolled (80%), and in 25 of the last 26 patients enrolled (96%; <i>p</i> = 0.07). Significantly less contrast was administered in the last 26 patients compared to the first 25 enrolled (110 (70, 140) mL vs. 120 (107, 150) mL; <i>p</i> = 0.045). Radial artery occlusion was reported in 1 patient (2%). Only 1 minor stroke (2%) was reported in-hospital and at 30-day follow-up. In conclusion, distal radial CAS using 5 Fr catheters was a safe procedure with a high success rate. The procedure had a relatively short learning curve in operators familiar with transfemoral CAS.https://www.mdpi.com/2075-4418/13/7/1266carotid artery diseasecarotid stentingradial artery |
| spellingShingle | Giuseppe Di Gioia Luigi Salemme Marco Ferrone Angelo Cioppa Grigore Popusoi Armando Pucciarelli Sebastiano Verdoliva Michele Franzese Simion Marga Emanuele Barbato Tullio Tesorio Carotid Artery Stenting Using Five-French Distal Radial Vascular Access Diagnostics carotid artery disease carotid stenting radial artery |
| title | Carotid Artery Stenting Using Five-French Distal Radial Vascular Access |
| title_full | Carotid Artery Stenting Using Five-French Distal Radial Vascular Access |
| title_fullStr | Carotid Artery Stenting Using Five-French Distal Radial Vascular Access |
| title_full_unstemmed | Carotid Artery Stenting Using Five-French Distal Radial Vascular Access |
| title_short | Carotid Artery Stenting Using Five-French Distal Radial Vascular Access |
| title_sort | carotid artery stenting using five french distal radial vascular access |
| topic | carotid artery disease carotid stenting radial artery |
| url | https://www.mdpi.com/2075-4418/13/7/1266 |
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