Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Distal Embolic Protection by Manual Compression of the Vertebral Artery in Subclavian Artery Stenting
Noriaki TashiroHiroto KawanoFumihiro HiraokaShuji FukudaYusuke NakamuraShigetoshi YanoHiroshi AikawaYoshinori GoKiyoshi KazekawaYoshihisa MatsumotoShinichi Yoshimura
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2021 Volume 15 Issue 4 Pages 254-259


Objective: There is no established method for preventing vertebral artery embolization in percutaneous transluminal angioplasty (PTA) for subclavian artery stenosis. We manually compressed the supraclavicular fossa outside the sternocleidomastoid muscle to disrupt vertebral artery blood flow and prevent embolism. We report the usefulness of this procedure.

Case Presentations: Between April 2017 and July 2018, three patients with severe stenosis of the subclavian artery of 80% or higher were examined. For these patients, subclavian artery stenting was performed. The approach was via the left brachial artery in one patient and right femoral artery in two patients. After crossing the lesion, the vertebral artery was manually compressed and angiography confirmed that blood flow was blocked. In all patients, stent placement was successfully performed and good dilatation was confirmed by angiography. There were no neurological complications and no findings suggestive of acute cerebral infarction were found on magnetic resonance imaging (MRI).

Conclusion: Prevention of distal embolism by manual compression is simple, does not require multiple catheters, and is useful for subclavian artery stenting.

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© 2021 The Japanese Society for Neuroendovascular Therapy

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