Novel Access Technique Facilitating Carotid Artery Stenting

Vascular ◽  
2006 ◽  
Vol 14 (4) ◽  
pp. 219-222 ◽  
Author(s):  
Krassi Ivancev ◽  
Timothy Resch ◽  
Martin Malina
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Common Femoral Artery ◽  
Novel Method ◽  
The Common ◽  
Vessel Tortuosity ◽  
Access Technique

Carotid artery stenting (CAS) may be impossible, or associated with a high risk, in patients with severe vessel tortuosity. A novel method of catheterization of the carotid artery intended to facilitate CAS is described. It involves the placement of a microcatheter and a coronary wire through a dissected superficial temporal artery (STA), and then advanced to the ascending aorta. The wire is then snared and brought out through a sheath already placed from the common femoral artery (CFA). Thus through-and-through access from the STA to the CFA is established. The sheath is then brought over the coronary artery into the common carotid artery. Using the coronary artery as "buddy wire" the carotid artery stenting is carried out in a standard fashion. The potential benefit of this new technique is the decrease of risk of the procedures in patients with prohibiting vessel tortuosity.

Percutaneous Superficial Temporal Artery Access for Carotid Artery Stenting in Patients With a Hostile Aortic Arch

2011 ◽  
Vol 18 (5) ◽  
pp. 729-733 ◽  
Author(s):  
Mubin I. Syed ◽  
Sukirtharin Sinnathamby ◽  
Azim Shaikh ◽  
Robert Tyrrell ◽  
Surender Neravetla ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Carotid Artery Stenting ◽  
Superficial Temporal Artery ◽  
Temporal Artery

scholarly journals New Pull-through Technique Using the Superficial Temporal Artery for Transbrachial Carotid Artery Stenting

2009 ◽  
Vol 49 (7) ◽  
pp. 320-324 ◽  
Author(s):  
Yutaka MITSUHASHI ◽  
Akimasa NISHIO ◽  
Taichiro KAWAKAMI ◽  
Kazunori SHIBAMOTO ◽  
Tohru YAMAGATA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Pull Through

scholarly journals Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report

2020 ◽  
Author(s):  
Ádám Csavajda ◽  
Olivier F Bertrand ◽  
Béla Merkely ◽  
Zoltán Ruzsa
Keyword(s):  
Coronary Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Coronary Intervention ◽  
Femoral Access ◽  
St Segment Elevation ◽  
Invasive Cardiology ◽  
Percutaneous Coronary ◽  
Diagnostic Angiography ◽  
The Right

Abstract Background The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology. Case summary We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access. Discussion We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.

Silent Coronary Artery Disease in Japanese Patients Undergoing Carotid Artery Stenting

2013 ◽  
Vol 22 (7) ◽  
pp. 1163-1168 ◽  
Author(s):  
Yukiko Enomoto ◽  
Shinichi Yoshimura ◽  
Kiyofumi Yamada ◽  
Masanori Kawasaki ◽  
Kazuhiko Nishigaki ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Japanese Patients ◽  
Silent Coronary Artery Disease ◽  
Artery Disease

scholarly journals Trapping, dome puncture, and direct suction decompression in conjunction with assistant superficial temporal artery- middle cerebral artery bypass to clip giant internal carotid artery bifurcation aneurysm

2019 ◽  
Vol 10 ◽  
pp. 205
Author(s):  
Seiei Torazawa ◽  
Hideaki Ono ◽  
Tomohiro Inoue ◽  
Takeo Tanishima ◽  
Akira Tamura ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Optimal Treatment ◽  
Aneurysm Neck ◽  
Bifurcation Aneurysm

Background: Very large and giant aneurysms (≥20 mm) of the internal carotid artery (ICA) bifurcation (ICAbif) are definitely rare, and optimal treatment is not established. Endovascular treatments are reported as suboptimal due to difficulties of complete occlusion and tendencies to recanalization. Therefore, direct surgery remains an effective strategy if the clipping can be performed safely and reliably, although very difficult. Case Description: Two cases of ICAbif aneurysms (>20 mm) were treated. Prior assistant superficial temporal artery (STA)-middle cerebral artery (MCA) bypass was performed to avoid ischemic complications during prolonged temporary occlusion of the arteries in both cases. In Case 1 (22-mm aneurysm), the dome was inadvertently torn in applying the clip because trapping had resulted in insufficient decompression. Therefore, in Case 2 (28-mm aneurysm), almost complete trapping of the aneurysm and subsequent dome puncture was performed, and the aneurysm was totally deflated by suction from the incision. This complete aneurysm decompression allowed safe dissection and successful clipping. Conclusion: Trapping, deliberate aneurysm dome puncture, and suction decompression from the incision in conjunction with assistant STA-MCA bypass can achieve complete aneurysm deflation, and these techniques enable safe dissection of the aneurysm and direct clipping of the aneurysm neck. Direct clipping with this technique for very large and giant ICAbif aneurysms may be the optimal treatment choice with the acceptable outcome if endovascular treatment remains suboptimal.

scholarly journals Retrograde three-dimensional rotational angiography: A novel method for the detection of plaque protrusion during carotid artery stenting under continuous distal balloon protection

2020 ◽  
Vol 26 (3) ◽  
pp. 316-320
Author(s):  
Hisayuki Hosoo ◽  
Wataro Tsuruta ◽  
Yusuke Hamada ◽  
Masahiro Katsumata ◽  
Daiichiro Ishigami ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Balloon Dilatation ◽  
Three Dimensional ◽  
Additional Treatment ◽  
Stent Deployment ◽  
Ischemic Complications ◽  
Novel Method ◽  
Stent Lumen ◽  
Balloon Protection

Background To prevent ischemic complications during carotid artery stenting, accurate detection of plaque protrusion and appropriate additional treatment are essential. Here, we introduce a novel method for the detection of plaque protrusion under distal balloon protection using three-dimensional rotation angiography—“retrograde 3DRA.” We evaluated the safety and efficacy of this method. Materials and methods We retrospectively analyzed 28 consecutive carotid artery stenting procedures under distal balloon protection at our hospital between July 2017 and August 2019. The first line of protection was dual balloon protection (proximal and distal balloon). After stent deployment, balloon dilatation, and subsequent blood aspiration, 3DRA was performed with the injection of diluted contrast medium from the aspiration catheter positioned just proximal to the distal protection balloon. The stent lumen was analyzed by obtaining the reconstruction maximum intensity projection image. Results Among the 28 cases, all cases could be assessed for in-stent plaque protrusion using “retrograde 3DRA.” We were able to evaluate the stent lumen clearly. There were three cases (10.7%) in which plaque protrusion could be confirmed. Since additional balloon dilatation was performed for all protrusion cases under continuing balloon protection, no ischemic complications occurred. Conclusion Retrograde 3DRA could be safe and useful for the detection of plaque protrusions and to avoid ischemic complication for tolerable cases of internal carotid artery transient balloon protection.

scholarly journals Direct Percutaneous Carotid Artery Stenting for a Patient with Absence of the Common Carotid Artery

2012 ◽  
Vol 18 (3) ◽  
pp. 320-325 ◽  
Author(s):  
S. Toyota ◽  
A. Wakayama ◽  
T. Yoshimine
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Postoperative Radiotherapy ◽  
Internal Carotid Artery Stenosis ◽  
Tonsillar Carcinoma ◽  
The Common

A 54-year-old man with symptomatic internal carotid artery stenosis with absence of the common carotid artery (CCA), who had been treated with surgery and postoperative radiotherapy for tonsillar carcinoma, underwent direct percutaneous carotid artery stenting (CAS). To our knowledge, this is the first report of direct percutaneous carotid artery stenting (CAS) for a patient with absent CCA.

Internal Carotid Artery Occlusion for Cavernous Segment Aneurysm

Neurosurgery ◽  
1989 ◽  
Vol 25 (3) ◽  
pp. 398-404 ◽  
Author(s):  
John R. Little ◽  
Jeffrey V. Rosenfeld ◽  
Issam A. Awad
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Brain Ischemia ◽  
Internal Carotid ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Flow Monitoring

Abstract We review our recent experience with occlusion of the cervical internal carotid artery (ICA) in 15 patients with symptomatic aneurysms of the cavernous segment. All the patients were women and ranged in age from 38 to 74 years. Ten patients sought treatment initially for ophthalmoplegia, 9 for retro-orbital pain, 8 for facial paresthesia, and 3 for loss of vision. Two patients had symptoms of transient ocular or brain ischemia. The diameter of the aneurysm was greater than 3 cm in 10 patients. Ten patients underwent gradual occlusion of the ICA by Selverstone clamp under anticoagulation and monitoring of neurological status. One patient underwent ligation of a severely stenotic ICA under general anesthesia and electroencephalographic monitoring. Four patients underwent trapping of the aneurysm (after attempts at direct obliteration) under electroencephalographic and cerebral blood flow monitoring. Two patients with incompetent circle of Willis collaterals underwent prophylactic superficial temporal artery to middle cerebral artery bypass surgery prior to ICA occlusion. There was no postoperative clinical change in 9 patients. Ophthalmoplegia improved in 2 patients, and facial pain improved in 3. Three patients developed new extraocular muscle palsies within hours of ICA occlusion; these resolved in all patients by 1 week postoperatively. No change in aneurysm size was documented by serial postoperative computed tomographic or magnetic resonance imaging scans. After a follow-up of 5 to 6 years (range, 6 months-9 years), 11 patients have remained neurologically stable. Two patients experienced delayed transient worsening of visual or facial symptoms. Two patients developed delayed ipsilateral brain ischemia: one patient had a visibly patent superficial temporal artery to middle cerebral artery bypass; the second patient had an occluded A-1 segment that previously had been patent. These results are discussed in light of direct approaches and recent techniques of intervention.

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