A Tailored Approach to Overcoming Challenges of a Bovine Aortic Arch During Left Internal Carotid Artery Stenting

2012 ◽  
Vol 19 (3) ◽  
pp. 329-338 ◽  
Author(s):  
Giorgio Ventoruzzo ◽  
Giuseppe Biondi-Zoccai ◽  
Filippo Maioli ◽  
Francesco Liistro ◽  
Leonardo Bolognese ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Aortic Arch ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Tailored Approach ◽  
Bovine Aortic Arch

scholarly journals Anatomical Predictors of Left Internal Carotid Artery Catheterization in Transradial Angiography

2021 ◽  
Author(s):  
Seon Woong Choi ◽  
Hoon Kim ◽  
Seong Rim Kim ◽  
Ik Seong Park ◽  
Sunghan Kim
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Internal Carotid ◽  
Multivariable Analysis ◽  
Innominate Artery ◽  
Left Internal Carotid Artery ◽  
Arch Height ◽  
Contrast Enhanced

ABSTRACTIntroductionTransradial angiography (TRA) has received considerable attention in the field of neurointervention owing to its advantages over transfemoral approaches. However, the difficulty of left internal carotid artery (ICA) catheterization under certain anatomical conditions of the aortic arch and its branches is a limitation of TRA. This study aimed to investigate the anatomical predictors of successful catheterization of the left ICA in TRA.Materials and MethodsFrom January 2020 to October 2020, 640 patients underwent TRA at a single institute. Among them, 263 consecutive patients who were evaluated by contrast-enhanced MRI before TRA were included in our study and assigned to success and failure groups, according to whether left ICA catheterization was possible or not. Anatomical predictors that may affect the success of left ICA catheterization in TRA were investigated for the purposes of our study.ResultsThe multivariable analysis included variables that demonstrated significant univariate associations with ICA catherization (P<0.0001). Variables included in the model were the type of aortic arch, height of right subclavian artery, turn-off angle of the left common carotid artery (CCA), distance between innominate artery to the left CCA, angulation of right subclavian artery, and angulation of the left CCA, which we identified as significant predictors of left ICA catheterization.ConclusionSuccess of left ICA catheterization in TRA was related to the vascular geometry of the aortic arch and its branches. Evaluating the anatomical predictors identified in this study using pre-procedure imaging may enhance the success rate of left ICA catheterization in TRA.

scholarly journals The use of curved sheath technique to facilitate difficult internal carotid artery occlusions

2021 ◽  
Vol 9 (37) ◽  
pp. 74-77
Author(s):  
Nitish Mittal ◽  
Sanjana Rao ◽  
Mohammad M. Ansari
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Aortic Arch ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Difficult Case ◽  
Ct Angiogram

Carotid Artery Occlusive Disease or Carotid Artery Stenosis (CAS), a widely prevalent disease, involves blockage of the arterial wall through atherosclerotic plaques. Due to the high prevalence of carotid artery stenosis, innovative approaches to improve the outcome are required, particularly for more difficult and unique cases. Within this report, we present a particularly difficult case of Type III Aortic Arch – Right Internal Carotid Artery (ICA) stenosis making it a challenging case. We describe a symptomatic 87-year-old male who presented to Cardiology clinic. CT angiogram showed 70% occlusion of right internal carotid artery and patient was deemed high risk for carotid artery surgery; hence, the patient underwent internal carotid artery stenting. After the procedure, angiogram results were excellent, and the patient was transferred to CICU in stable hemodynamic condition. This case demonstrates the significance of innovative new techniques in the development of medical treatment.  Keywords: Carotid Artery Stenting, Curve Sheath Technique, Type 3 Aortic Arch, Right Internal Carotid Artery Stenosis

scholarly journals Cerebral Hyperperfusion Syndrome following Protected Carotid Artery Stenting

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Rainer Knur
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Rare Complication ◽  
Left Internal Carotid Artery ◽  
Cerebral Hyperperfusion Syndrome ◽  
Hyperperfusion Syndrome ◽  
Cerebral Hyperperfusion ◽  
Almost All

The cerebral hyperperfusion syndrome is a very rare complication after revascularization of the carotid artery and accompanied by postoperative or postinterventional hypertension in almost all patients. We report a case of a 77-year-old man who developed a complete aphasia and increased right-sided weakness following endovascular treatment of severe occlusive disease of the left internal carotid artery. We discuss the risk and management of cerebral hyperperfusion syndrome after carotid artery stenting.

scholarly journals Left internal carotid artery agenesis with trans-sellar collateral and a right aortic arch: Case report

2015 ◽  
Vol 21 (6) ◽  
pp. 759-764 ◽  
Author(s):  
Masakazu Okawa ◽  
Toshio Higashi ◽  
Masaki Komiyama ◽  
Kenji Fukuda ◽  
Hiroshi Abe ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Aortic Arch ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Right Aortic Arch ◽  
Neurological Deficits ◽  
Left Internal Carotid Artery ◽  
Structure Recognition ◽  
The Right

We present a case of unilateral internal carotid artery (ICA) agenesis with trans-sellar anastomosis associated with a right aortic arch, and discuss the embryonic development and clinical implications of this condition. A 26-year-old woman without significant medical history was referred to our hospital complaining of tinnitus. She denied any other symptoms, and examination did not reveal any other neurological deficits. Radiological examinations showed agenesis of the right ICA with trans-sellar anastomosis, and a right aortic arch. This vascular configuration reflects the anatomical homology with avian vascular structure. Recognition of this anomaly has important implications for clinical situations, such as the planning of carotid or transsphenoidal surgery, the management of thromboembolic disease, and the surveillance and detection of associated cerebral aneurysms.

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