Transradial Versus Transfemoral Carotid Artery Stenting: A 16‐Year Single‐Center Experience

Mendiz, Oscar; Fava, Carlos; Lev, Gustavo; Caponi, Gaspar; Valdivieso, León

doi:10.1111/joic.12342

Cited by 44 publications

(39 citation statements)

References 11 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 Ao-Om or IM count in the left radial group. 5 Ao-RCA (aorta to right coronary artery) graft count in the right radial group. 6 Ao-RCA count in the left radial group.…”

Section: Resultsmentioning

confidence: 99%

“…In studies related to coronary angiography and percutaneous intervention that were conducted in recent years, transradial access has left its disadvantage in terms of time and performance relative to the transfemoral route, and advantageous in terms of complications [3][4][5] . Recently, radial access has been used for the purpose of carotid and renal artery angiography [6][7][8] , transradial access has been used for acute ischemic stroke intervention [9] , but femoral access is still advantageous from the point of view of the radiation exposure dose of the operator [10] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Safety of "Coronary Artery Bypass Graft Angiography" with Right Transradial Access versus Left Transradial Access and Femoral Access: a Retrospective Comparative Study

Balaban¹,

Akbaş²,

Akbaş³

et al. 2019

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

Objective Over the past 10 years, the rate of patients who have undergone coronary artery bypass graft (CABG) surgery has increased twofold in cases of coronary angiography. Today, transradial access is the first choice for coronary angiography. We aimed to compare the efficacy and reliability of radial versus femoral access for coronary angiography in post-CABG surgery in this study. Methods Data from 442 patients who underwent post-CABG surgery between 2012-2017 were retrospectively compared. The right radial route was used in 120 cases, the left radial route in 148, and femoral route in 174. These three pathways were compared in terms of procedure time and fluoroscopy time, efficacy, and complication development. Comparisons among the three groups were performed with Bonferroni test for continuous variables and chi-square or Fisher's exact test for nominal variables as a binary. Results Comparison results indicate that femoral access was better than left radial access and the left radial access was better than right radial access in terms of fluoroscopy time (10.71±1.65, 10.94±1.25, 16.12±5.28 min, P <0.001) and total procedure time (17.28±1.68, 17.68±2.34, 23.04±5.84 min, P <0.001). The left radial pathway was the most effective way of viewing left internal mammary artery (LIMA). No statistically significant differences were found among the three groups in other graft visualizations, all minor complications, total procedure and fluoroscopy time " Except LIMA imaging ". Mortality due to processing was not observed in all three groups. Conclusion The left radial route is preferred over right radial access for post-CABG angiography because the left radial pathway is close to the LIMA and is similar to the femoral pathway. In LIMA graft imaging, right radial access is a reliable route, even though it is not as effective as other pathways. We hope that the right radial pathway will improve with physician experience and innovations.

show abstract

“…4 Ao-Om or IM count in the left radial group. 5 Ao-RCA (aorta to right coronary artery) graft count in the right radial group. 6 Ao-RCA count in the left radial group.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of "Coronary Artery Bypass Graft Angiography" with Right Transradial Access versus Left Transradial Access and Femoral Access: a Retrospective Comparative Study

Balaban¹,

Akbaş²,

Akbaş³

et al. 2019

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…A study from Argentina compared transradial vs transfemoral CAS[32]. A total of 775 consecutive patients undergoing CAS during 16 years were included (101 transradial vs 674 transfemoral).…”

Section: Head-to-head Comparison/combination Of Strategiesmentioning

confidence: 99%

“…Angiographic success was achieved in all 775 patients. There was a significant difference in cross-over rate (4.9% vs 0%, for the transradial vs the transfemoral approach, respectively; P < 0.05), but not in the incidence of in-hospital major adverse cardiac and cerebral events (2% vs 3.6%, for the transradial vs transfemoral approach, respectively; P = not significant)[32]. It was concluded that both approaches are safe and efficacious.…”

Section: Head-to-head Comparison/combination Of Strategiesmentioning

confidence: 99%

Transcervical access, reversal of flow and mesh-covered stents: New options in the armamentarium of carotid artery stenting

Paraskevas

Veith

2017

WJC

View full text Add to dashboard Cite

In the last 25 years, the very existence of carotid artery stenting (CAS) has been threatened on a number of occasions. The initial disappointing results that even lead to the discontinuation of an early randomized controlled trial have improved considerably with time. Novel devices, advanced stent and equipment technology, alternative types of access and several types of filters/emboli protecting devices have been reported to reduce stroke/death rates during/after CAS and improve CAS outcomes. The present review will provide a description of the various technology advances in the field that aim to reduce stroke and death rates associated with CAS. Transcervical access, reversal of flow and mesh-covered stents are currently the most promising tools in the armamentarium of CAS.

show abstract

“…Аналогичная техника стентирования через ТР-доступ была адаптирована для лечения стенотических поражений каротидных артерий [5]. На сегодняшний день было проведено одно рандомизированное [8] и несколько нерандомизированных исследований по сравнению ТР-и ТФ-доступов при КС [9,10], однако ни одно из этих исследований не коснулось вопроса микроэмболических поражений головного мозга (ГМ) после процедуры, выявляемых на диффузионно-взвешенной магнитно-резонансной томографии (ДВ МРТ).…”

Section: Introductionunclassified

Transradial and Transfemoral Access for Carotid Artery Stenting With an Emphasis on the Detection of Microembolization With Diffusion Weighted Magnetic Resonance Imaging (Tactile Trial).

Малаев¹,

Кретов²,

Байструков³

et al. 2018

Kompleks. probl. serdečno-sosud. zabol.

View full text Add to dashboard Cite

Aim. To compare transradial (TR) and transfemoral (TF) approach for carotid artery stenting (CAS) with an emphasis on the detection of micro-embolization with diffusion-weighted magnetic resonance imaging (DW-MRI).Methods. 96 patients were included in the study in the period from January 2015 to October 2017 with further randomized 1 : 1 to the TR and TF groups. The inclusion criteria were the following: symptomatic stenosis ICA >70%; or asymptomatic stenosis ICA >80%. The positive history of stroke, myocardial infarction or open heart surgery <1 month were the exclusion criteria for the study. The primary endpoint was the incidence of new cerebral ischemic lesions as assessed by DW-MRI. All CAS procedures were performed by two experienced operators according to the approved protocol.Results. Procedural success with TR approach was 46 (96%) versus 48 (100%) with TF approach (p = 0.495). Crossover rate was 4% in the TR group. The rate of primary endpoint in the TR and TF groups was 50 and 52%, respectively. The absolute risk difference was -2% (95% CI [-0.21, 0.17], p (non-inferiority) = 0.03). An «on-treatment» analysis revealed a tendency towards a reduced microembolic foci when intervening on the right ICA via TR approach compared to TF (44% vs. 68%, p = 0.478), and a reverse trend when intervening on the left ICA via TR compared to TF approach (57% versus 36%, respectively, p = 0.437).Conclusion. Carotid stenting via transradial approach is noninferior for cerebral embolism to transfemoral approach. The rates of MACCE and vascular complications were similar in both groups. There was no significant difference in the procedural success rate in the transfemoral and transradial groups. The fluoroscopy time during transradial carotid stenting was higher in comparison with transfemoral carotid stenting, though the procedure duration was similar in both groups.

show abstract

Transradial Versus Transfemoral Carotid Artery Stenting: A 16‐Year Single‐Center Experience

Abstract: The TR approach for CAS is safe and efficacious, with acceptable cross-over rate. In both groups, vascular complications rarely occurred.

Cited by 44 publications

References 11 publications

Efficacy and Safety of "Coronary Artery Bypass Graft Angiography" with Right Transradial Access versus Left Transradial Access and Femoral Access: a Retrospective Comparative Study

Efficacy and Safety of "Coronary Artery Bypass Graft Angiography" with Right Transradial Access versus Left Transradial Access and Femoral Access: a Retrospective Comparative Study

Transcervical access, reversal of flow and mesh-covered stents: New options in the armamentarium of carotid artery stenting

Transradial and Transfemoral Access for Carotid Artery Stenting With an Emphasis on the Detection of Microembolization With Diffusion Weighted Magnetic Resonance Imaging (Tactile Trial).

Contact Info

Product

Resources

About