Abstract
Objective: We designed a direct road map method during carotid artery stenting (CAS) in March 2015, and evaluated the effectiveness of this method in the present study.
Method: A Mo. Ma Ultra (MoMa) device is used as the introducing catheter. Both balloons of the MoMa device (the distal balloon in the external carotid artery and the proximal balloon in the common carotid artery) are inflated and a tolerance test is performed. If a negative result is obtained in the tolerance test, a PercuSurge GuardWire (PSGW) is advanced into the internal carotid artery (ICA) as a distal embolic protection device. Contrast medium is then slowly injected from the MoMa device, and the ICA is filled with contrast medium. The PSGW is inflated during this injection, and contrast medium is trapped in the ICA. This trapped contrast medium is continuously checked during CAS.
Result: Both the MoMa device and the PSGW were introduced into the target vessel in seven lesions. Among the seven lesions, direct road mapping was clinically useful in five lesions.
Discussion: Straightening of the vessel occasionally happens, especially during deployment of a stent. An image obtained during conventional road mapping sometimes tilts with the straightening of the vessel. Direct road map solves this problem.
Conclusion: The direct road map method using a MoMa device and a PSGW is useful during CAS.
