Feasibility and safety of transradial arterial approach for simultaneous right and left vertebral artery angiographic studies and stenting.
OBJECTIVE
This study investigated whether the transradial artery (TRA) approach using a 6-French (F) Kimny guiding catheter for right vertebral artery (VA) angiographic study and stenting is safe and effective for patients with significant VA stenosis.


BACKGROUND
The TRA approach is commonly performed worldwide for both diagnostic cardiac catheterization and catheter-based coronary intervention. However, to our knowledge, the safety and feasibility of left and right VA angiographic study and stenting, in the same procedure, using the TRA approach for patients with brain ischemia have not been reported.


METHODS
The study included 24 consecutive patients (22 male,2 female; age, 63-78 years). Indications for VA angiographic study and stenting were (1) prior stroke or symptoms related to vertebrobasilar ischemia and (2) an asymptomatic but vertebral angiographic finding of severe stenosis (>70%). A combination of the ipsilateral and retrograde-engagement technique, which involved a looping 6-F Kimny guiding catheter, was utilized for VA angiographic study. For VA stenting, an ipsilateral TRA approach with either a Kimny guiding catheter or a left internal mammary artery guiding catheter was utilized in 22 patients and retrograde-engagement technique in 2 patients.


RESULTS
A technically successful procedure was achieved in all patients, including left VA stenting in 15 patients and right VA stenting in 9 patients. The mean time for stenting (from engagement to stent deployment) was 12.7 min. There were no vascular complications or mortality. However, one patient suffered from a transient ischemic attack that resolved within 3 h.


CONCLUSIONS
We conclude that TRA access for both VA angiographic study and VA stenting is safe and effective, and provides a simple and useful clinical tool for patients unsuited for femoral arterial access.
Yip
Hon-Kan
HK
Division of Cardiology, Chang Gung Memorial Hospital- Kaohsiung Medical Center, Chang Gung University Collage of Medicine, Kaohsiung, Taiwan, ROC.
Youssef
Ali A
AA
Chang
Wen-Neng
WN
Lu
Cheng-Hsien
CH
Yang
Cheng-Hsu
CH
Chen
Shyh-Ming
SM
Wu
Chiung-Jen
CJ
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery; D011859:Radiography; D012107:Research Design; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy*