Carotid stenting access: key tips from Drs. Ruiz Chiriboga & Leal Lorenzo

In this PVI 2025 exclusive discussion, Dr. Diego Ruiz Chiriboga and Dr. José Ignacio Leal Lorenzo explore one of the most critical decisions in carotid stenting: choosing the optimal vascular access.

They review the main options — transfemoral, transcarotid, and transradial — highlighting the advantages and limitations of each. Their key message: planning is essential. Similar to EVAR cases, carotid stenting requires thorough pre-procedural imaging, including CT or MRI of the aortic arch and supra-aortic trunks, to anticipate anatomical challenges and select the most suitable access route.

Proper imaging helps evaluate the arch, the origin of the supra-aortic vessels, and intracranial circulation, ensuring procedural success and patient safety. They also emphasise translating guidelines and recommendations into practice for both standard-risk and high-risk patients, while relying on professional experience to choose what fits best for each team and setting.

Watch the full discussion to learn how careful access planning can improve outcomes in carotid stenting procedures.