A selective cannulation of left common carotid artery
was performed using 5F Headhunter catheter. After cannulation, a 0.035"
stiff wire was placed into external carotid artery. An 8Fr, 90-cm long shuttle
sheath was positioned in the left common carotid artery over stiff wire.
The Guardwire could be advanced beyond the second turn in the carotid artery
(Figure
2). To reduce the time of balloon occlusion, predilatation balloon was
positioned at the tip of shuttle sheath. And then, the occlusion balloon
was inflated to 4.5-mm diameter. Predilatation was done with a 3.0 x 20
mm balloon at nominal pressure two times under distal protection. A self-expanding
7 mm x 40 mm carotid Wallstent was positioned and expanded from the left
common carotid artery lesion to left internal carotid artery following predilation.
Adjunctive balloon dilation was performed with a 4.0 mm x 20 mm balloon
at 16 atm several times (Figure
3 and Figure
4). Following stenting, the embolic debris was aspirated using Export
catheter. Large amount of atheroembolic debris was aspirated. Total distal
balloon occlusion time was 420 seconds. The final result is shown in Figure
5. The patient had no neurological deficit and was discharged the following
day. |
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