Complex carotid stenting using a coronary technique

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Seyed Ebrahim KassaianMehran Mahmoodian

Abstract

To report the utility of a coronary technique to facilitate carotid stenting in patients with difficult arch anatomies. When confronted with challenging arch anatomy that prevents engaging the common carotid artery (CCA) with the guiding sheath using standard techniques, an 8-F left Amplatz guiding catheter (AL1) is placed at the origin of the innominate artery. A 0.014-inch coronary guidewire is advanced into the external carotid artery (ECA), and a small monorail coronary balloon is inflated in a small branch of the ECA. The balloon/guidewire combination facilitates maneuvering a 0.035-inch Amplatz super-stiff guidewire through the ECA and then advancing the guiding catheter into the CCA. This anchoring technique can be a helpful method for cannulating the CCA in patients with a complex arch when the ECA is patent.

References

Feb 1, 1996·Journal of Endovascular Surgery : the Official Journal of the International Society for Endovascular Surgery·E B DiethrichD B Reid
Feb 14, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Mitsugu HirokamiHarutatsu Muto

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