Transradial carotid artery stenting: examining the alternatives when femoral access is unavailable

Carotid artery stenting with embolic protection has been shown to be a proven alternative to carotid endarterectomyin patients with significant carotid disease. The transfemoral approach is the conventional access site for carotid stenting. Access site complications are the most common adverse event after carotid stentingfrom the femoral access and most technical failures are related to a complex aortic arch. As demonstrated in multiple studies, transradial approach reduces access site bleeding and vascular complications in coronary interventional procedures. It may offer a more direct and safer approach in cases involving a complex arch. Previous feasibility studiesand case reports have demonstrated that transradial access may be a viable alternative strategy in these patients.