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European Radiology

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01-05-2013 | Vascular-Interventional

Carotid artery stenting in difficult aortic arch anatomy with or without a new dedicated guiding catheter: preliminary experience

Authors: Giulio Barbiero, Diego Cognolato, Andrea Casarin, Rudi Stramanà, Elisa Galzignan, Alessandro Guarise

Published in: European Radiology | Issue 5/2013

Abstract

Objectives

To evaluate carotid artery stenting (CAS) procedures with or without a new dedicated guiding catheter in anatomically challenging aortic arches in our experience.

Methods

We retrospectively reviewed 172 procedures of CAS performed from December 2006 to October 2011 in 159 consecutive patients (100 men, mean age 78 years): 15 patients had type III aortic arch, 13 had a bovine aortic arch, 6 had an acute angle at the origin of the left common carotid artery from the aortic arch, 2 had type III aortic arch with bovine aortic arch, and 1 had a bicarotid trunk with an aberrant right subclavian artery. In this group of difficult anatomy (37 cases), CAS was performed with (13 cases) or without (24 cases) a new dedicated guiding catheter.

Results

Mean time of fluoroscopy (16 min vs. 18 min, P < 0.01), mean total procedural time (68 min vs. 83 min, P < 0.001), technical failure (0/13 vs. 3/24 cases, P = 0.01), clinical failure (0/13 vs. 4/21 cases, P = 0.02) and local complications (0/13 vs. 2/24 cases, P < 0.0001) were significantly lesser in the dedicated guiding catheter group.

Conclusions

The new dedicated guiding catheter may be more effective and less risky for CAS in anatomically challenging aortic arches.

Key Points

• Complex anatomy of the aortic arch is not rare

• Endovascular carotid artery stenting (CAS) is more difficult when the anatomy is complex

• A new dedicated guiding catheter may help CAS when the arch anatomy is complex

• The new dedicated guiding catheter may be less risky in complex arches

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Title: Carotid artery stenting in difficult aortic arch anatomy with or without a new dedicated guiding catheter: preliminary experience
Authors: Giulio Barbiero
Diego Cognolato
Andrea Casarin
Rudi Stramanà
Elisa Galzignan
Alessandro Guarise
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 5/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2708-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Carotid artery stenting in difficult aortic arch anatomy with or without a new dedicated guiding catheter: preliminary experience

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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