title: Transradial approach for vertebral artery stenting.
abstract: Symptomatic severe vertebral artery (VA) stenosis may be treated safely with stent supported angioplasty via femoral access. There is limited clinical data on transradial approach for VA angioplasty in case of peripheral artery disease.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of transradial angioplasty of symptomatic VA stenosis.
  
  
  METHODS
  Fifteen patients (age 66 ±7.4 years, 73% men, with VA > 80% stenosis, 11 right-side, all symptomatic from posterior circulation (history of stroke, TIA, or chronic ischaemia symptoms)) with peripheral artery disease (PAD) or unsuccessful attempt via femoral approach were scheduled for VA angioplasty by radial access. Clinical and duplex ultrasound (DUS) follow-up were performed before discharge and 1, 12, and 24 months after VA angioplasty.
  
  
  RESULTS
  The technical success rate was 100%. In all cases VA angioplasty was performed with the use of single balloon-mounted stent (9 bare metal stents, 6 drug-eluting stents). The mean NASCET VA stenosis was reduced from 85.3% to 5.3% (p < 0.001). No periprocedural death, stroke, myocardial infarction, or transient ischaemic attack occurred. During 24-months follow-up, in 12 of 15 patients chronic ischaemia symptoms release was observed, and no new acute ischaemic neurological symptoms were diagnosed in all patients. One patient died 20 months after intervention from unknown causes. There was one symptomatic borderline VA in-stent stenosis 12 months after angioplasty.
  
  
  CONCLUSIONS
  Transradial VA stenting may be a very effective and safe procedure, and it may constitute an alternative to the femoral approach in patients with symptomatic VA stenosis.
authors.affiliation: Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Maciejewski
authors.affiliation: Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Tekieli
authors.affiliation: Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kabłak-Ziembicka
authors.affiliation: Department of Vascular Surgery and Endovascular Interventions, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Paluszek
authors.affiliation: Department of Vascular Surgery and Endovascular Interventions, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Trystuła
authors.affiliation: Department of Neurology, John Paul II Hospital, Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wójcik-Pędziwiatr
authors.affiliation: Department of Vascular Surgery and Endovascular Interventions, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Machnik
authors.affiliation: Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pieniążek
keywords: peripheral artery disease; radial approach; vertebral artery stenting
references.citation: Am Heart J. 2012 Apr;163(4):632-48
references.pmid: 22520530
references.citation: Arch Neurol. 1998 Apr;55(4):470-8
references.pmid: 9561974
references.citation: Stroke. 1988 Sep;19(9):1083-92
references.pmid: 3413804
references.citation: Lancet. 1991 Jun 22;337(8756):1521-6
references.pmid: 1675378
references.citation: J Endovasc Ther. 2004 Aug;11(4):511-6
references.pmid: 15298506
references.citation: EuroIntervention. 2013 Mar;8(11):1242-51
references.pmid: 23354100
references.citation: J Invasive Cardiol. 2013 Oct;25(10):529-36
references.pmid: 24088428
references.citation: Clin Neuroradiol. 2015 Dec;25(4):379-86
references.pmid: 24920183
references.citation: EuroIntervention. 2014 Jul;10 (3):381-91
references.pmid: 25042266
references.citation: Postepy Kardiol Interwencyjnej. 2014;10(1):47-9
references.pmid: 24799929
references.citation: Neurosurgery. 2009 Aug;65(2):E378-9; discussion E379
references.pmid: 19625893
references.citation: J Am Coll Cardiol. 2010 Feb 9;55(6):538-42
references.pmid: 20152558