Comparison of a Sheathless Transradial Access With Looping Technique and Transbrachial Access for Carotid Artery Stenting

J Endovasc Ther. 2016 Jun;23(3):516-20. doi: 10.1177/1526602816640291. Epub 2016 Mar 22.


Purpose: To evaluate the feasibility and safety of sheathless transradial access (TRA) with the looping technique for carotid artery stenting (CAS) compared with the transbrachial approach (TBA).

Methods: Among 99 symptomatic patients with a history of transient ischemic attack (TIA) or stroke, 38 patients (mean age 69±10 years; 28 men) with documented internal carotid artery stenosis were selected for CAS via a sheathless TRA and compared with 61 patients who received CAS via the brachial artery. Routine assessments of radial artery patency using duplex ultrasound and clinical follow-up were performed at 1, 6, and 12 months.

Results: The sheathless TRA technique offered 100% procedure success; only 1 patient in the sheathless TRA group and 2 patients in the TBA group experienced TIAs during the procedure. There were no major complications (major stroke or 30 day in-hospital death) in either group or radial access site complications. The incidence of radial artery occlusion in the sheathless TRA CAS group was 9% (3/33) at 1 year (5 patients died unrelated to the procedure).

Conclusion: The sheathless TRA with looping technique may be an alternative to transbrachial access for CAS in patients who have small radial arteries and are unsuitable for the transfemoral approach.

Keywords: brachial artery; carotid artery stenting; looping technique; radial artery occlusion; sheathless technique; transbrachial approach; transradial approach.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Angiography
  • Angioplasty / adverse effects
  • Angioplasty / instrumentation*
  • Angioplasty / methods*
  • Brachial Artery* / diagnostic imaging
  • Carotid Artery, Internal* / diagnostic imaging
  • Carotid Artery, Internal* / physiopathology
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / therapy*
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Ischemic Attack, Transient / etiology
  • Male
  • Middle Aged
  • Punctures
  • Radial Artery* / diagnostic imaging
  • Stents*
  • Stroke / etiology
  • Taiwan
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency