title: [A Novel, Less Invasive Protection Method for Carotid Artery Stenting].
abstract: Purpose: We present a novel, less invasive protection method for carotid artery stenting.Case presentation: A 67-year-old man presented with symptomatic severe left carotid artery stenosis. A transfemoral approach was dangerous because of an abdominal aortic aneurysm. A 6Fr Axcelguide Simmonds catheter was inserted into the right brachial artery, and advanced into the left common carotid artery. Next, a 6Fr Optimo 100-cm catheter was coaxially navigated into the left common carotid artery. A PercuSurge GuardWire 300-cm was coaxially navigated into the left external carotid artery. Under flow reversal with the 2 balloons, another PercuSurge GuardWire 300-cm was navigated into the distal left internal carotid artery through the lesion. After both PercuSurge GuardWire balloons were inflated, the 6Fr Optimo was deflated and retrieved using a catheter exchange technique. Then, under distal double-balloon protection, routine stenting was performed.Conclusions: This technique is safer and less invasive than previous methods, especially in cases with difficult femoral access and vulnerable carotid plaque.
authors.affiliation: Department of Neurosurgery, Kariya Toyota General Hospital.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ohshima
authors.forename: Shunsaku
authors.initials: S
authors.lastname: Goto
authors.forename: Taiki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Tasuku
authors.initials: T
authors.lastname: Imai
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Shimato
authors.forename: Kyozo
authors.initials: K
authors.lastname: Kato
mesh_terms: D000368:Aged; D000792:Angiography; D002339:Carotid Arteries; D016893:Carotid Stenosis / Q000601:surgery*; D002404:Catheterization; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D015607:Stents