scholarly journals TCTAP A-048 A Downsizing of Carotid Artery Stenting with Proximal Protection Method Using “Sheathless OPTIMO Guiding Catheter System”

2014 ◽  
Vol 63 (12) ◽  
pp. S14
Author(s):  
Tomoyuki Umemoto ◽  
Takamichi Miyamoto ◽  
Toru Obayashi ◽  
Mitsuaki Isobe
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Protection Method ◽  
Catheter System ◽  
Proximal Protection ◽  
Guiding Catheter

scholarly journals Novel triple coaxial system to navigate 9 French balloon guiding catheter into common carotid artery

2020 ◽  
Vol 26 (6) ◽  
pp. 719-724
Author(s):  
Ryuta Yasuda ◽  
Naoki Toma ◽  
Yume Suzuki ◽  
Yoichi Miura ◽  
Masato Shiba ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
External Carotid Artery ◽  
External Carotid ◽  
Type Iii ◽  
Catheter System ◽  
Bovine Aortic Arch ◽  
Guiding Catheter

Background It is often hard to navigate a 9 French (F) balloon guiding catheter in patients with type III or bovine aortic arch. Also, a common carotid artery stenosis is challenging, because a guidewire cannot be advanced distally. We developed the combination of a 4F Simmons-type catheter and a 6F distal access catheter as a coaxial inner catheter to navigate a 9F balloon guiding catheter to overcome these difficulties. Materials and methods Medical record at our institution was retrospectively reviewed and carotid artery stenting cases in which the 4F Simmons-6F distal access catheter system was employed as a coaxial catheter to navigate a 9F balloon guiding catheter were identified. To construct this system, a 4F 145 cm SY3 (Hanako Medical, Saitama, Japan) and a 6F 118 cm Cerulean DD6 (Medikit Co. Ltd., Tokyo, Japan) were usually employed. A rotating hemostatic valve should be as short as possible and was attached to only a 9F balloon guiding catheter. The length of a 0.035-in. guidewire needed to be 180 cm or longer. Results During the study period, 106 carotid artery stenting cases were identified. Of these, this system was employed in 29 cases that included 5 cases with a steno-occlusive lesion at common carotid artery/external carotid artery, 10 with type III or bovine arch, and 11 harboring both. In all the cases, a 9F balloon guiding catheter was successfully navigated. Conclusion The 4F Simmons-6F distal access catheter system was useful in navigating a 9F balloon guiding catheter in patients with a common carotid artery stenosis, an external carotid artery occlusion, and an in-stent restenosis, especially when they also harbored type III or bovine aortic arch.

scholarly journals Navigation of a 6-French guiding sheath into the common carotid artery using a tri-axial catheter system in transbrachial carotid artery stenting

2018 ◽  
Vol 25 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Shigeyuki Sakamoto ◽  
Toshinori Matsushige ◽  
Masaru Abiko ◽  
Koji Shimonaga ◽  
Masahiro Hosogai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Catheter System ◽  
The Common ◽  
The Right ◽  
Distal Filter ◽  
Balloon Protection ◽  
Guiding Catheter

Background and purpose Placement of a large-bore guiding sheath or catheter into the common carotid artery (CCA) is crucial in transbrachial carotid artery stenting (CAS). Herein, we describe technical tips for the navigation of a 6-French guiding sheath into the CCA using a tri-axial catheter system in transbrachial CAS. Materials and methods A total of 27 patients underwent transbrachial CAS. For the right side, a 6-French straight guiding sheath was navigated directly into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French straight guiding catheter. For the left side, a 6-French Simmons guiding sheath was navigated into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French Simmons guiding catheter. After the placement of a 6-French guiding sheath into the CCA, CAS was performed under distal filter or balloon protection. Results Fifteen patients had a right carotid stenosis and 12 patients had a left carotid stenosis. The 6-French guiding sheath was safely placed with ease and provided adequate stabilization for CAS. All procedures were successfully performed without any complications. Conclusion The use of a tri-axial catheter system for the navigation of a 6-French guiding sheath into the CCA appears safe and efficient, allowing transbrachial CAS, with 6-French guiding sheath stabilization, to be performed without any complication.

Carotid artery stenting with double cerebral embolic protection in asymptomatic patients – a diffusion-weighted MRI controlled study

VASA ◽  
2017 ◽  
Vol 46 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Ertan Vuruskan ◽  
Erhan Saracoglu ◽  
Ugur Ergun ◽  
Fatih Poyraz ◽  
İrfan Veysel Duzen
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Controlled Study ◽  
Diffusion Weighted Mri ◽  
Embolic Protection ◽  
Diffusion Weighted ◽  
Protection Method ◽  
Asymptomatic Patients ◽  
Proximal Protection ◽  
Distal Filter

Abstract. Background: The aim of this study was to compare the simultaneous double-protection method (proximal balloon plus distal filter) with distal-filter protection or proximal-balloon protection alone in asymptomatic patients during carotid artery stenting. Patients and methods: 119 consecutive patients were investigated for carotid artery stentings in the extracranial internal carotid artery with the use of distal filters (n = 41, 34.4 %), proximal balloon (MoMa) protection (n = 40, 33.6 %) or double protection (n = 38, 31.9 %). Magnetic resonance imaging (MRI) was performed on all patients before the procedure, and control diffusion-weighted MRI (DW-MRI) was obtained within 24–48 h after the procedure. Procedural data, complications, success rate, major adverse cardiovascular events, and MRI findings were collected. Results: New cerebral high-intensity (HI) lesions were observed in 47 (39.4 %) patients. HI lesions were observed in 22 (53.6 %), 15 (37.5 %), and 10 (26.3 %) of the patients with distal filters, proximal protection, and double protection, respectively (p = 0.004). The average number of HI lesions on DW-MRI was 1.80 in the distal-filter group, 0.90 in the proximal-balloon group, and 0.55 in the double-protection group (p < 0.001). Procedure and fluoroscopy times were slightly longer in the double-protection group compared to the distal- or proximal-protection groups (p = 0.001). Conclusions: The double (proximal plus distal) cerebral embolic protection technique is safe and effective for minimizing the risk of cerebral embolization, even in patients with asymptomatic carotid artery stenosis, despite slightly longer procedure and fluoroscopy times.


scholarly journals Effect of aortic arch type on technical indicators in patients undergoing carotid artery stenting

2018 ◽  
Vol 47 (2) ◽  
pp. 682-688 ◽  
Author(s):  
Songhe Shen ◽  
Xiongjing Jiang ◽  
Hui Dong ◽  
Meng Peng ◽  
Zhixue Wang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Contrast Agent ◽  
Aortic Arch ◽  
Carotid Artery Stenting ◽  
Influential Factor ◽  
Fluoroscopy Time ◽  
Type I ◽  
Technical Indicators ◽  
Type Iii ◽  
Guiding Catheter

Objective This study was performed to explore the effect of the aortic arch type on technical indicators in patients undergoing carotid artery stenting (CAS). Methods The data of 224 consecutive patients who underwent unilateral CAS from January 2011 to December 2012 were retrospectively analyzed. The requirement for placement of the guiding catheter into the common carotid artery with assistance of an angiographic catheter, fluoroscopy time, contrast agent dose, and adverse events were recorded. Results The fluoroscopy time was significantly longer and the contrast agent dose was significantly higher in patients with Type III than Type I and II arches. Significantly more patients with Type III than Type I and II arches required placement of the guiding catheter with assistance of an angiographic catheter (46.2% vs. 15.0%, respectively). The procedural success rate was significantly lower in patients with Type III than Type I and II arches (96.2% vs. 100.0%, respectively). The incidence of death, myocardial infarction, and all types of stroke was significantly higher in patients with Type III than Type I and II arches (7.7% vs. 1.7%, respectively). Conclusions The aortic arch type is an important influential factor in CAS. Type III arches are associated with more difficulties and complications.

scholarly journals Carotid artery stenting for patients with occipital–vertebral anastomosis

2018 ◽  
Vol 25 (2) ◽  
pp. 212-218
Author(s):  
Ryuichiro Kajikawa ◽  
Toshiyuki Fujinaka ◽  
Hajime Nakamura ◽  
Manabu Kinoshita ◽  
Takeo Nishida ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
High Intensity ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
External Carotid ◽  
Occipital Artery ◽  
Protection Method ◽  
Distal Internal Carotid Artery

Background and purpose We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery–vertebral artery anastomosis. Methods Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery–vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery. Results One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery–vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion. Conclusion Large occipital artery–vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.

Limiting Complications During Carotid Artery Stenting in Complex Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 66
Author(s):  
Fabrizio Fanelli ◽  
Emanuele Boatta ◽  
Pierleone Lucatelli ◽  
Roberto Passariello ◽  
◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Plaque Morphology ◽  
Permanent Disability ◽  
The Us ◽  
Protection Systems ◽  
Proximal Protection ◽  
Protection Devices ◽  
Distal Occlusion ◽  
Selection Of

Stroke is the third leading cause of death and permanent disability in the US and Europe. During the last decade, carotid artery stenting (CAS) has gained a role as an alternative option to carotid endoarterectomy (CEA). Both patient selection and plaque morphology are crucial to reduce the risk of complications. Technical aspects such as the employment and selection of different types of cerebral protection devices, distal occlusion balloons, filters, proximal protection systems and stent selection will be widely discussed.

Use of a guide wire system to insert guiding catheters

2010 ◽  
Vol 112 (6) ◽  
pp. 1232-1234 ◽  
Author(s):  
Tetsuya Nagayama ◽  
Yosuke Nishimuta ◽  
Sei Sugata ◽  
Teruhiko Nishizawa ◽  
Kazunori Arita
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Guide Wire ◽  
Anatomical Variations ◽  
Wire System ◽  
Guiding Catheter ◽  
Bovine Arch

In patients with severe arteriosclerosis or anatomical variations such as a bovine arch, the insertion of a guiding catheter for carotid artery stenting is difficult. The authors use a guide wire system as an anchor and advance the guiding catheter to an area proximal to the stenotic structure. This method is useful and safer than others for carotid artery stenting.

scholarly journals Transient neurological deficites due to proximal protection in carotid artery stenting

2019 ◽  
Vol 25 (1) ◽  
pp. 48-51
Author(s):  
Mustafa Gökçe ◽  
Buket Cemile Tuğan Yıldız ◽  
Şerife Çöklü
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Proximal Protection
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