Carotid stenting with distal-balloon protection via the transbrachial approach.
OBJECTIVE
To document the feasibility of brachial artery access for carotid stenting with distal-balloon protection of the internal carotid artery (ICA).


METHODS
Via percutaneous access to the brachial artery, a large double-curve catheter is advanced into the aortic arch over a hydrophilic guidewire to cannulate the left common carotid artery. Following sheath exchange, a GuardWire distal-protection balloon is positioned within the left ICA distal to the stenosis. The lesion is dilated, followed by deployment and dilation of a self-expanding stent. Transcranial Doppler monitoring shows only scarce microembolic signals during the procedure.


CONCLUSIONS
Carotid stenting with distal balloon protection via the brachial artery appears feasible as an alternative to standard femoral access.
Al-Mubarak
N
N
The Lenox Hill Heart and Vascular Institute, New York, New York 10021, USA.
Vitek
J J
JJ
Iyer
S S
SS
New
G
G
Roubin
G S
GS
D000368:Aged; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D001916:Brachial Artery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002404:Catheterization; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D011859:Radiography; D015607:Stents