Turkish Neurosurgery 2025 , Vol 35 , Num 1
Brachial Artery Access for Carotid Artery Stenting: A Pooled Analysis
Marcelo Porto SOUSA1,Sávio BATISTA1,Guilherme Melo SILVA1,Márcio Yuri FERREIRA2,Leonardo de Barros OLIVERA3,José Victor Dantas dos SANTOS4,Raphael Muszkat BESBORODCO5,Filipi Fim ANDREÃO1,Agostinho C PINHEIRO6,Raphael BERTANI7,José Alberto Almeida FILHO8
1Federal University of Rio de Janeiro, Faculty of Medicine, Rio de Janeiro, Brazil
2Ninth July University - São Paulo, Faculty of Medicine, São Paulo, Brazil
3State University of Ponta Grossa, Faculty of Medicine, Paraná, Brazil
4Center University Estácio of Ceará, Faculty of Medicine, Iguatu Campus, Ceará, Brazil
5Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
6Massachusetts General Hospital, Brigham and Women?s Hospital, Harvard Medical School, Department of Neurology, Boston, Massachusetts, USA
7University of São Paulo, Department of Neurosurgery, São Paulo, Brazil
8Municipal Hospital Miguel Couto, Department of Neurosurgery, Rio de Janeiro, Brazil
DOI : 10.5137/1019-5149.JTN.46534-24.2 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. Keywords : Brachial, Carotid, Carotid artery stenting, Stent, Transbrachial

Corresponding author : José Victor Dantas dos SANTOS, jvdantas999@gmail.com