P.118 Radial to femoral “through and through” access for high grade ostial subclavian and innominate artery stenoses: a novel technique

Abstract

Background: Endovascular approaches are typically preferred to open surgical techniques for symptomatic subclavian/innominate artery stenosis. Due to individual patient anatomy, endovascular treatment from a conventional femoral arterial approach can be technically challenging. Our alternative technique using a combined radial to femoral artery approach can facilitate an otherwise challenging revascularization procedure. Methods: Retrospective analysis between November 2017 to March 2021 yielded five procedures (in four patients) using a combined radial to femoral “through and through” access and stenting technique. Results: All patients presented with hypoperfusion symptoms, either to their extremities, brain, or both. Technical success was achieved in 100% of the five vessels treated in four patients with symptomatic subclavian/innominate artery stenosis using this approach. One of the patients developed a recurrent stenosis after 40 months, requiring a repeat procedure. Three patients received treatment to the left subclavian artery and one to the innominate artery. All of the patients experienced marked symptomatic improvement without significant complications. Conclusions: A combined radial to femoral “through and through” access technique is a simple and safe method to achieve successful recanalization of high grade symptomatic ostial stenoses of the subclavian and innominate arteries.