Abstract
The standard technique of PTA/stenting using the PercuSurge (PS) guardwire system was introduced in this paper. Initially, PS was introduced beyond the stenosis of the internal carotid artery and the distal internal carotid artery was obliterated for one minute to examine the neurological status of the patient. Then, the occlusion balloon was deflated and inflated again. Predilatation, stenting, and aspiration of the debris were performed under distal ICA occlusion in the same session. If the dilation was unsatisfactory, post dilatation was added under distal balloon occlusion. A balloon catheter with the same diameter as the normal distal ICA was chosen as the predilatation PTA balloon catheter. By using a large balloon in the process of predilatation, postdilatation was unnecessary in 80-90% of cases. The morbidity/mortality rate was 1.7% (minor stroke) in our 60 cases, although in two cases with pseudoocclusion crossing the lesion by PS failed. The PS system enabled total protection during the carotid stenting and reduced the rate of embolic complications during carotid stenting. However, this system was a little bit complicated and fragile. Therefore, adequate training is necessary before using this system for carotid stenting.
