title: Dual guidewire placement to enhance arch vessel origin identification: a simple technique to facilitate ostial aortic arch vessel stenting.
abstract: Orificial occlusive lesion involving the aortic arch vessels is commonly treated with balloon-expandable stent placement. Stenting of such a lesion typically involves an initial aortogram to precisely identify the vessel origin, followed by deployment of a balloon-expandable stent to cover the ostial lesion. We report a simple technique of an antegrade femoral guidewire placement along the outer curvature of the aortic arch to facilitate the identification of the origin of aortic arch vessels. This enhanced ostial visualization enables a precise positioning and deployment of a balloon-expandable stent in aortic arch vessels. This dual guidewire technique facilitates the visual identification of arch vessel origin and reduces potential contrast requirement, which provides procedural benefit in patients with renal insufficiency or contrast allergy.
authors.affiliation: Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Nasim
authors.initials: N
authors.lastname: Hedayati
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kougias
authors.forename: Hosam F
authors.initials: HF
authors.lastname: El Sayed
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Tam T
authors.initials: TT
authors.lastname: Huynh
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D011859:Radiography; D015607:Stents