Radial Versus Femoral Access For Carotid Artery Stenting

Exclusion Criteria

• •1. Progressive stroke.
• •2. Allergic to drugs associated with carotid artery stenting, such as lidocaine, aspirin, clopidogrel, etc.
• •3. Allergic to contrast media or interventional device.
• •4. Any active hemorrhage, severe anemia, coagulation disorders, or unnecessary blood transfusion treatment. Meet at least one of the following laboratory tests: hemoglobin \< 10g/dL, or platelet count \< 100000 /μ L, or unadjusted INR \>1.5, or PT beyond upper limit of normal for 1 minute, or heparin-induced thrombocytopenia.
• •5. Previous ipsilateral large cerebral infarction stroke with sequelae, which can affect the judgment of the study end point.
• •6. Severe cognitive disorder, unable to cooperate with treatment or postoperative evaluation.
• •7. Spontaneous intracranial hemorrhage occurred 12 months prior to informed consent written. Ischemic stroke hemorrhage transformation occurred 3 months prior to informed consent signed.
• •8. A new-onset stroke occurred 7 days prior to informed consent signed, which has a high hemorrhagic transformation risk after preoperative imaging evaluation.
• •9. Any condition that could interfere with digital subtraction angiography (DSA) or make percutaneous arterial access unsafe.
• •10. Neurological disorders occurred 2 years prior to informed consent signed, which has transient or fixed neurological deficits, cannot be distinguished from TIA or stroke.
• •11. Participating in other clinical trials, in the research phase or follow-up phase.
• •12. Unable to understand or sign the informed consent.
• •13. Myocardial infarction within 30 days.
• •14. High surgical risk, intolerance to interventional surgery, e.g., coronary artery stenosis ≥70% without or unable to revascularization; ejection fraction \< 30% or NYHA classification ≥class III; stable angina pectoris (static angina pectoris with ECG changes); organ transplantation (such as heart, lung, liver and kidney) planned or under evaluation; malignant tumour or respiratory insufficiency making life expectancy less than 5 years or FEV1\< 30%(prediction); dialysis-dependent renal failure; poorly controlled diabetes mellitus(fast serum glucose \>400 mg/dl and urine ketone \> +2).
• •15. Diseases or anatomical features that would prevent from carotid artery stenting, such as pathway problems caused by cervical radiation therapy, and cervical space occupying lesion compressing carotid artery
• •1. Severe vascular tortuosity or dissection that influence catheters delivering
• •2. Stenting, balloon dilation or coiling were performed in ipsilateral vessels in the past.
• •3. Extensive or diffuse atherosclerotic disease involving the aortic arch and the proximal common carotid artery, which would influence catheters delivering
• •4. Besides the target vessel, there are also ipsilateral intracranial or extracranial arteries stenosis larger than the target lesion, aneurysms with the longest diameter ≥5 mm, cerebrovascular AVM(arteriovenous malformation), or other cerebrovascular disease with abnormal cerebral angiography.
• •5. Ipsilateral carotid artery chronic occlusions.
• •6. Plan to perform endovascular tretment of other arteries at the same time, including vertebral arteries.