A potential pitfall in the use of the monorail system for carotid stenting. A technical case report.
The use of EPDs seems to be necessary for safe CAS. Though the monorail system may offer advantages for a single operator, we caution its use with certain aortic arch anatomies. In such anatomies, using an OTW system or at least a 300 cm filter wire or devices that support wire extension will remedy some complications, such as the loss of the guiding sheath. As in our case, the added advantage of a 300 cm filter wire enabled us to avoid a poor outcome or an emergency vascular surgery.
Pereira
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Neurointerventional Service, Department of Radiology, South Jackson Street, Louisville, USA - ssachio@med.kitasato-u.ac.jp.
Birnbaum
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