A Case of Carotid Artery Stenting through Surgical Exposure and Direct Puncture of the Femoral Artery with Severe Arteriosclerosis Obliterans: A Technical Note

Abstract

Objective: A case of carotid artery stent placement performed by exposing and directly puncturing the femoral artery through a small surgical incision is reported.Case Presentations: In this patient, who had undergone multiple bypass surgeries for arteriosclerosis obliterans of the bilateral lower extremities, the inguinal region was scarred and atrophied, and percutaneous puncturing of the femoral artery was difficult. In addition, the possible area of device insertion was limited to a short segment of the left femoral artery. Also, as stenting through the right brachial artery was difficult due to flexion contracture of the elbow as a sequela of cerebral infarction, stent placement was performed by surgically exposing and puncturing the femoral artery under local anesthesia.Conclusion: This stenting method was useful as it could be performed similarly to the usual percutaneous stenting procedure under local anesthesia with limited physical and psychological burden to the patient.