Radial and ulnar approach for carotid artery stenting with Roadsaver™ double layer micromesh stent: Early and long‐term follow‐up

Petkoska, Danica; Zafirovska, Biljana; Vasilev, I; Novotni, Gabriela; Bertrand, Olivier; Kedev, Saško

doi:10.1002/ccd.30514

Cited by 9 publications

(8 citation statements)

References 49 publications

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“…The connection between BMI and the diameter of the distal radial artery is still up for debate. [20] The dTRA was initially described with the objective of recanalizing occluded radial artery retrogradely [10] . Later it was proposed to use this access route for preserving the entire radial artery and by this radial artery could also be used in future surgical procedures [11] .…”

Section: Discussionmentioning

confidence: 99%

A Cross Sectional Study on the Safety and Efficacy of Distal Trans-Radial Access (DTRA) for Coronary Intervention in Individuals with Low BMI

Khan¹,

Shah²,

Saood³

et al. 2023

PJMHS

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Objective: The research aimed for examining the safety and effectiveness of distal trans-radial access (dTRA), a new coronary intervention procedure, in individuals with low BMI. Methods: The design of this study was a cross sectional study design. This study was conducted at Mayo Hospital Lahore and the duration of this study was from December 2020 to December 2022. The participants of this study was 67 patients who had a coronary intervention. The patients were divided into two groups: 38 patients had traditional trans-radial access (cTRA) and 29 patients got direct trans-radial access (dTRA). Results: The research outcomes indicated that the success rates for puncture procedures in both groups, dTRA and cTRA, were not significantly different. Specifically, the success rate for dTRA was found to be 96.6% while cTRA recorded a success rate of 97.4%. This difference was not considered to be statistically significant as the p-value was 0.846, which means there was an 84.6% chance that the results were due to random chance and not a true difference between the groups. This indicates that both dTRA and cTRA are effective in puncture procedures and can produce similar results in terms of success rate. It is crucial to consider these results alongside the limitations of the research. Despite the overall results indicating a similar success rate between the two groups, there was a disparity in success rates for single-needle puncture procedures. In this aspect, the cTRA group outperformed the dTRA group with a success rate of 81.6% compared to 51.7% for the dTRA group. This difference was statistically significant with a p-value of 0.020, indicating that the results were not due to random chance. However, the dTRA group did have some advantages over the cTRA group. The compression hemostasis time, the time required for the bleeding to stop, was faster for the dTRA group, with a p-value of 0.01. Additionally, the incidence of radial artery occlusion was less frequent in the dTRA group compared to the cTRA group, with a p-value of 0.007 (4% compared to 33.3% in the cTRA group). Practical Implication: The study examines the first-time use of dTRA in low BMI people and looks at efficacy and safety. With a success rate of 96.6% in the dTRA group and a success rate of 97.4% in the control group (cTRA), the puncture success rate was found to be comparable between the two groups. The success rate was lower in the dTRA group compared to the cTRA group, and it took them longer to penetrate the skin with a single needle. The two groups' puncture-related side effects, such as bleeding and hematoma, were not significantly different from one another. Even though the dTRA group's patients reported more comfort, the dTRA group's compression hemostasis time and Visual Analog Scale (VAS) ratings were lower. Conclusion: The research shows that in individuals with low BMI, coronary intervention with dTRA is both secure and efficient. This approach offers a less complicated, more effective, and efficient alternative to conventional trans-radial access. Keywords: Conventional Trans-Radial Access, Body Mass Index, Percutaneous Coronary Intervention, Bleeding, Puncture

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Section: Discussionmentioning

confidence: 99%

A Cross Sectional Study on the Safety and Efficacy of Distal Trans-Radial Access (DTRA) for Coronary Intervention in Individuals with Low BMI

Khan¹,

Shah²,

Saood³

et al. 2023

PJMHS

View full text Add to dashboard Cite

show abstract

“…The connection between BMI and the diameter of the distal radial artery is still up for debate. (20) The study examines the first-time use of dTRA in low BMI people and looks at efficacy and safety. With a success rate of 96.6% in the dTRA group and a success rate of 97.4% in the control group (cTRA), the puncture success rate was found to be comparable between the two groups (P-value = 0.846).…”

Section: Discussionmentioning

confidence: 99%

An Observational Study on the Efficacy and Safety of Coronary Intervention Via Distal Transradial Access (STRA) in Patients

Ali¹,

Ibrar²,

Aqeel³

et al. 2021

PJMHS

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Objective: The aim of this study was to examine the safety and effectiveness of distal trans-radial access (dTRA), a new coronary intervention procedure, in individuals with low BMI. Methods: The design of this study was an observational study design. This study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, and the duration of this study was from December 2020 to December 2022. 67 patients who had a coronary intervention at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The sample was divided into two groups: 38 patients had traditional trans-radial access (cTRA) and 29 patients got direct trans-radial access (dTRA). Results: The research outcomes indicated that the success rates for puncture procedures in both groups, dTRA and cTRA, were not significantly different. Specifically, the success rate for dTRA was found to be 96.6% while cTRA recorded a success rate of 97.4%. This difference was not considered to be statistically significant as the p-value was 0.846, which means there was an 84.6% chance that the results were due to random chance and not a true difference between the groups. This indicates that both dTRA and cTRA are effective in puncture procedures and can produce similar results in terms of success rate. It is crucial to consider these results alongside the limitations of the research. Despite the overall results indicating a similar success rate between the two groups, there was a disparity in success rates for single-needle puncture procedures. In this aspect, the cTRA group outperformed the dTRA group with a success rate of 81.6% compared to 51.7% for the dTRA group. This difference was statistically significant with a p-value of 0.020, indicating that the results were not due to random chance. However, the dTRA group did have some advantages over the cTRA group. The compression hemostasis time, the time required for the bleeding to stop, was faster for the dTRA group, with a p-value of 0.01. Additionally, the incidence of radial artery occlusion was less frequent in the dTRA group compared to the cTRA group, with a p-value of 0.007 (4% compared to 33.3% in the cTRA group). Conclusions: In the conclusion of this study, individuals with low BMI, coronary intervention with dTRA is both secure and efficient. This approach offers a less complicated, more effective, and efficient alternative to conventional trans-radial access. Keywords: Trans-Radial Access, Body Mass Index, Percutaneous Coronary Intervention, Hemostasis, Vascular. Radial Artery Occlusion.

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“…The transradial approach (TRA) has become the standard of care for cardiac catheterisation and coronary interventions. Its benefits are also well documented in peripheral interventions, including CAS, leading to a reduced risk of bleeding and access site complications, early ambulation and discharge and, ultimately, cost saving 28 .…”

Section: Transradial Casmentioning

confidence: 99%

“…The technical failure of CAS through the femoral approach in most of the cases is due to a complex aortic arch. Features that increase the risk of complications during CAS procedures are some type 2 & 3 arches, bovine arch and plongeant innominate arteries 28 .…”

Section: Transradial Casmentioning

confidence: 99%

“…This alternative approach may reduce the time for catheter manipulation in the aortic arch and supraaortic vessels, thus directly limiting the CAS-associated stroke risk 29 . Devices featuring low crossing-profile delivery systems are facilitating the TRA and yielding excellent results 28 . However, large-bore devices can be used only selectively in patients with larger-size radial arteries.…”

Section: Transradial Casmentioning

confidence: 99%

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Carotid artery interventions - endarterectomy versus stenting

Kedev

2023

AsiaIntervention

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Current management of patients with carotid artery stenosis is based on well-established guidelines, including surgical procedures − carotid endarterectomy (CEA) and endovascular carotid artery stenting (CAS) − and optimal medical treatment alone. Outcomes in the postprocedural period after CAS and CEA are similar, suggesting strong clinical durability for both treatments. Recent advances, which include the emergence of novel endovascular treatment tools and techniques, combined with more recent randomised trial data shed new light on optimal patient selection and treatment in contemporary practice. Improved, modern technologies including enhanced embolic protection devices and dual-layered micromesh stents yield better outcomes and should result in further improvements in CAS. In centres of excellence, nowadays, the majority of patients with severe carotid artery stenosis can be successfully treated with either CEA or CAS.

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Radial and ulnar approach for carotid artery stenting with Roadsaver™ double layer micromesh stent: Early and long‐term follow‐up

Abstract: Aims: We aimed to evaluate the feasibility and safety of carotid artery stenting (CAS) with a newly designed double-layer micromesh stent using wrist approach in patients with significant carotid disease.

Cited by 9 publications

References 49 publications

A Cross Sectional Study on the Safety and Efficacy of Distal Trans-Radial Access (DTRA) for Coronary Intervention in Individuals with Low BMI

A Cross Sectional Study on the Safety and Efficacy of Distal Trans-Radial Access (DTRA) for Coronary Intervention in Individuals with Low BMI

An Observational Study on the Efficacy and Safety of Coronary Intervention Via Distal Transradial Access (STRA) in Patients

Carotid artery interventions - endarterectomy versus stenting

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