title: The coronary technique for complex carotid artery stenting in the setting of complex aortic arch anatomy.
abstract: Carotid artery stenting (CAS) remains a viable option for treating carotid artery lesions in high surgical risk patients. We retrospectively reviewed our experience in performing CAS in patients with complex aortic arch anatomy. The ''coronary technique'' uses an AL1 guiding catheter to engage the origin of the common carotid artery permitting delivery of protection device and stent. In total, 12 patients had complex arch anatomy which precluded access using the standard technique as determined on preoperative imaging. A total of 8 patients with such anatomy underwent femoral artery catheterization with placement of an Amplatz AL1 guide catheter into the common carotid artery. All were able to be successfully treated, with no dissection, neurovascular deficit, or other major complication. Based on this case series, we describe the coronary technique as a safe and viable method for CAS in the setting of complex anatomy which might otherwise preclude CAS.
authors.affiliation: Division of Vascular Surgery, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: B
authors.initials: B
authors.lastname: Solomon
authors.forename: T
authors.initials: T
authors.lastname: Berland
authors.forename: N
authors.initials: N
authors.lastname: Cayne
authors.forename: C
authors.initials: C
authors.lastname: Rockman
authors.forename: F J
authors.initials: FJ
authors.lastname: Veith
authors.forename: T
authors.initials: T
authors.lastname: Maldonado
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology*; D001027:Aortography / Q000379:methods; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D009519:New York City; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome