2017 Volume 2 Issue 1 Pages 36-41
Objective: We report a novel technique of the proximal balloon protection (PBP) during internal carotid artery stenotic lesion crossing, and the following total distal balloon protection (TDBP) for transbrachial carotid artery stenting (TB-CAS) with 7Fr-guiding sheath.
Case presentation: A 83-year-old male patient presented with an asymptomatic severe stenosis in the right internal carotid artery (ICA) complicated with ipsilateral occipital-vertebral artery anastomosis and severe aortic arch atherosclerosis. A 7Fr-guiding sheath was inserted into the right brachial artery and navigated into the right common carotid artery (CCA). The PBP was obtained by inflating the separately advanced GuardWire in the external carotid artery (ECA) and the 5.2Fr Selecon MP Catheter in the distal CCA. The TDBP was achieved with the following process; (1) a second GuardWire was navigated into the distal ICA under the PBP through the Selecon MP Catheter, and then inflated to achieve the distal protection, (2) The Selecon MP Catheter was deflated and withdrawn, (3) the inflated GuardWires in the ICA and ECA complete the TDBP. Then TB-CAS was performed under TDBP without any complication.
Conclusion: This protection technique enables the PBP and the subsequent TDBP with a 7Fr-guiding sheath and may be useful when performing TB-CAS.
