title: Safety of Slender 5Fr Transradial Approach for Carotid Artery Stenting With a Novel Nitinol Double-Layer Micromesh Stent.
abstract: We aimed to evaluate the feasibility and safety of performing percutaneous carotid stent implantation with a newly designed double-layer stent using transradial slender 5Fr techniques. We recruited 10 consecutive patients who underwent percutaneous carotid stenting using nitinol double-layer micromesh (Roadsaver) stents. Mean age of patients was 66 years. Seven patients had ≥2 high-risk criteria according to SAPPHIRE classification. Indication was neurologic symptoms in 7 and severe lesion without symptoms in 3 cases. Type 2 aortic arch was present in 8 patients and type 1 in 2 patients. Access was right radial artery in 9 cases and right ulnar artery in 1 case. Right carotid artery was stented in 4 cases and left carotid artery in 6 cases. Embolic protection device (EPD) was used in 6 cases. Nine stents were successfully delivered using 5Fr destination sheath (n = 7) or shuttle sheath (n = 2), and 1 was implanted using Mo-Ma 8Fr proximal EPD. Procedural success was obtained in all cases with only 1 case of temporary vasospasm due to distal EPD. Total procedural time was 21 minutes (13 to 30 minutes) with filter time of 5 ± 1 minutes. Fluoroscopy time was 8 minutes (5 to 12 minutes) and contrast volume was 150 ml (100 to 200 ml). Hospital stay was 1 ± 1 day with 4 patients discharged on the same day of the procedure. Using right transradial approach and slender 5Fr techniques, this new double-layer micromesh stent can be implanted in left and right carotid arteries with promising results.
authors.affiliation: Interventional Cardiology Department, University Clinic of Cardiology, Skopje, Macedonia. Electronic address: skedev@mt.net.mk.
authors.forename: Sasko
authors.initials: S
authors.lastname: Kedev
authors.affiliation: Interventional Cardiology Department, University Clinic of Cardiology, Skopje, Macedonia.
authors.forename: Danica
authors.initials: D
authors.lastname: Petkoska
authors.affiliation: Interventional Cardiology Department, University Clinic of Cardiology, Skopje, Macedonia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Zafirovska
authors.affiliation: Interventional Cardiology Department, University Clinic of Cardiology, Skopje, Macedonia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vasilev
authors.affiliation: Interventional Cardiology, Quebec Heart-Lung Institute, Quebec, Quebec, Canada.
authors.forename: Olivier F
authors.initials: OF
authors.lastname: Bertrand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D002340:Carotid Artery Diseases / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D057505:Embolic Protection Devices; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D017534:Radial Artery; D015607:Stents; D013526:Surgical Mesh
chemical_list: D000497:Alloys; C013616:nitinol