Abstract
Recently, development of low-profile devices has made the transbrachial approach to carotid artery stenting (CAS) possible. A technical method for CAS with distal balloon protection using a transbrachial approach developed by this group is presented. A 4-French (Fr) Simmons catheter was advanced into the external carotid artery over a 0.035-inch guide wire. This was then exchanged for a long half-stiff wire. The Simmons catheter was removed over the wire, which was then used to position a 6Fr shuttle sheath. The stenotic lesion was crossed using a distal-protection balloon and predilated using a coronary balloon. A self-expanding stent was then deployed. Our experience is that CAS via the brachial approach is technically safe and feasible.
