title: Brachial artery approach for transluminal angioplasty of the internal carotid artery.
abstract: One possible problem in internal carotid angioplasty is inaccessibility of the lesion due to elongation of the aortic arch, the brachiocephalic trunk, or the carotid artery itself. A new approach to performing angioplasty of the right or left internal carotid artery utilizing the brachial artery was used after failure of the transfemoral approach in 5 lesions (4 patients). The common carotid artery was cannulated with performed 5F catheters. Angioplasty was performed with a conventional balloon dilatation catheter. If required, a Wall stent was implanted to optimize the angiographic result. After failure of the conventional transfemoral technique, the brachial technique permitted successful angioplasty of the ipsilateral internal carotid artery in 4 lesions and the contralateral internal carotid artery in 1 lesion. In 1 patient, a stent was implanted. No complications occurred. The mean stenosis diameter decreased from 77.8 +/- 6.3% to 17.8 +/- 9.1%. Doppler sonography performed 4-6 months later showed no restenosis. The brachial artery approach seems to be a suitable alternative to the femoral technique.
authors.affiliation: Cardioangiologisches Centrum Bethanien, Frankfurt, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Sievert
authors.forename: R
authors.initials: R
authors.lastname: Ensslen
authors.forename: A
authors.initials: A
authors.lastname: Fach
authors.forename: H
authors.initials: H
authors.lastname: Merle
authors.forename: C
authors.initials: C
authors.lastname: Rubel
authors.forename: H
authors.initials: H
authors.lastname: Spies
authors.forename: N
authors.initials: N
authors.lastname: Sultan
authors.forename: K F
authors.initials: KF
authors.lastname: Beykirch
authors.forename: R
authors.initials: R
authors.lastname: Theis
authors.forename: H J
authors.initials: HJ
authors.lastname: Schultze
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001916:Brachial Artery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography; D018608:Ultrasonography, Doppler