title: Transradial Versus Transfemoral Carotid Artery Stenting: A 16-Year Single-Center Experience.
abstract: OBJECTIVE
  Limited data exist on radial access in carotid artery stenting (CAS). This single-center study was performed to compare the outcome and complication rates of transradial (TR) and transfemoral (TF) CAS.
  
  
  RESULTS
  The clinical and angiographic data of 775 consecutive patients with high risk for carotid endarterectomy, treated between 1999 and 2016 by CAS with cerebral protection, were evaluated. Patients were divided into 2 groups according to vascular access: TR (n = 101; 13%) and TF (n = 674). Primary combined end-point: in-hospital major adverse cardiac and cerebral events. Secondary end-points: angiographic outcome of the procedure and crossover rate to another puncture site. Angiographic success was achieved in all 775 patients, the crossover rate was 4.9% in the TR and 0% in the TF group (P < 0.05). TR was performed at the right side in 97% of cases. The incidence of in-hospital major adverse cardiac and cerebral events was 2% in the TR and 3.6% in the TF group (P = ns).
  
  
  CONCLUSIONS
  The TR approach for CAS is safe and efficacious, with acceptable cross-over rate. In both groups, vascular complications rarely occurred.
authors.affiliation: Department of Interventional Cardiology and Cardiovascular Surgery, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Mendiz
authors.affiliation: Department of Interventional Cardiology and Cardiovascular Surgery, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fava
authors.affiliation: Department of Interventional Cardiology and Cardiovascular Surgery, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Lev
authors.affiliation: Department of Interventional Cardiology and Cardiovascular Surgery, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Gaspar
authors.initials: G
authors.lastname: Caponi
authors.affiliation: Department of Interventional Cardiology and Cardiovascular Surgery, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: León
authors.initials: L
authors.lastname: Valdivieso
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D001118:Argentina / Q000453:epidemiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002318:Cardiovascular Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D017534:Radial Artery / Q000601:surgery*; D020379:Risk Adjustment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome