Objective: To investigate the effect and safety of transradial stent angioplasty using double guide wires for severe stenosis of vertebral artery ostium at a lower location.
Methods: Patients with severe stenosis of the vertebral artery ostium at a lower location treated with transradial stent angioplasty were retrospectively enrolled. All the clinical and endovascular treatment data were analyzed.
Results: Thirty-nine patients were enrolled. A low location of the vertebral artery ostium was present in 33 (84.6%) patients and an ultra-low location in 6 (15.4%). Transradial stent angioplasty was performed in all patients. In one patient who had a tortuous radial artery, the transradial access was failed. In the other 38 (97.4%) patients, transradial stent angioplasty was all successful. The sharp angle formed between the vertebral artery and the subclavian artery was significantly (P < 0.0001) increased from 15° to 65° (36° ± 11°) before to 70-125° (90° ± 17°) after insertion of a support guide wire. No damage was found in all support guide wires. Thirty-nine stents were deployed, and the preoperative stenosis rate of 70%-98% (85% ± 13%) was significantly (P < 0.0001) decreased to 0-25% (16%) immediately after stenting. Six-12 months after surgery, 29 (74.4% or 29/39) patients were followed up with imaging, and 9 (31.0%) patients experienced in-stent restenosis, with endovascular retreatment being performed in 3 (33.3%) patients.
Conclusions: Transradial stent angioplasty using double guide wires is safe and effective for the treatment of severe stenosis of the vertebral artery ostium at a lower location even though more studies are necessary to confirm this.
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http://dx.doi.org/10.1016/j.wneu.2024.10.023 | DOI Listing |
J Clin Med
December 2024
Department of Neurosurgery, Myodani Hospital, Kobe 655-0852 Hyogo, Japan.
Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.
View Article and Find Full Text PDFInterv Neuroradiol
December 2024
Department of Neurology, University of Chicago, Chicago, IL, USA.
Carotid artery stenting (CAS) has been established as an effective surgical treatment for internal carotid artery stenosis and/or common carotid artery stenosis (ICAS/CCAS). Typically, CAS is performed via a transfemoral, transbrachial, or transradial approach. However, direct puncture CAS (DP-CAS) is preferred in cases where conventional access routes are challenging, such as in the presence of cervical vascular tortuosity or thoracic aortic aneurysm.
View Article and Find Full Text PDFWorld Neurosurg
November 2024
Stroke Center, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China.
Curr Opin Anaesthesiol
December 2024
Ohio State University Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Purpose Of Review: To evaluate the current trends, safety, and feasibility of same-day discharge (SDD) in ambulatory cardiac procedures, with a focus on percutaneous coronary interventions (PCI). This review also discusses the impact of technological advancements and explores future directions for expanding the scope of SDD in more complex cardiac procedures.
Recent Findings: Recent studies have demonstrated that SDD after PCI is both well tolerated and effective for appropriately selected patients, with outcomes comparable with those of patients who remain hospitalized overnight.
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