Brachial Artery Access for Carotid Artery Stenting: A Pooled Analysis.

Abstract

Aim: To examine the potential of transbrachial access (TBA) in carotid artery stenting (CAS).

Material and methods: This systematic review and meta-analysis aimed to comprehensively evaluate the safety and efficacy of TBA for CAS by conducting a thorough search on Medline, Cochrane Library, Embase, and Web of Science databases. Studies reporting TBA for CAS and evaluating primary outcomes such as good neurological results, procedural success, and complications were included. Studies with fewer than 4 patients were excluded.

Results: After a meticulous selection of 1837 literature articles, 11 studies were meticulously chosen for the comprehensive examination, involving a total of 273 patients. The analysis of nine studies revealed a consistent 100% procedural success rate with minimal variability (95% CI: 98% to 100%). In the final assessment of neurological status across eight studies, good neurological outcomes were observed in 99% (95% CI: 98% to 100%). Additionally, nineteen complications were identified, leading to a 1% rate (95% CI: 0% to 9%). Among the 223 patients in eight studies, resulting in a pooled estimate of 0% mortality (95% CI: 0% to 1%), indicating a favorable safety profile.

Conclusion: The results of TBA for CAS demonstrate a highly effective and safe procedure. Despite the limitations, TBA can be an option in patients with no other access available, and further comparative studies are required to establish definitive conclusions.