Introduction: We previously reported the safety and usefulness of transradial iliac artery stenting using 6Fr sheath as a less invasive treatment strategy. However, during the study, we experienced several cases of radial artery occlusion after the procedure.
Hypothesis: Iliac artery stenting using a 4.5 Fr long sheath can prevent radial artery occlusion.
Methods: We performed transradial iliac artery stenting using a 4.5Fr long sheath with 110cm length for 34 lesions in 29 patients. Clinical data were analyzed retrospectively. Cases with scheduled multiple sheath insertion for bidirectional approach were excluded.
Results: Twenty three (79.3%) patients were male. Diabetes mellitus, hypertension, dyslipidemia, and smoking habit were 11 (37.9%), 27 (93.1%), 19 (65.5%), and 24 (82.8%) patients, respectively. Nine lesions (26.5%) were chronic total occlusion. All lesions were successfully treated with a total of 40 stents using a 4.5 Fr radial access system. Ankle brachial index (ABI) significantly improved from 0.68±0.15 to 0.99±0.17 (p<0.0001). None of the patients had any procedural or access site-related complications such as hematoma, major bleeding, blood transfusion, stroke, cholesterol embolism, aortic dissection, or arterial perforation. Radial artery occlusion was 0%. ABI value was well maintained to 0.98±0.13 in one year, and there was no target lesion revascularization.
Conclusions: Slender transradial iliac artery stenting using a 4.5 Fr long sheath is safe and feasible without radial artery occlusion for carefully selected patients.