Skip to main content
Log in

Endovascular stenting of symptomatic innominate artery stenosis under distal balloon protection of the internal carotid and vertebral artery for cerebral protection: a technical case report

  • Case Report
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

The use of cerebral protection devices in endovascular treatment for innominate artery (IA) stenosis is not well established. We describe a novel technique for cerebral protection during endovascular stenting of symptomatic IA stenosis. An 82-year-old man presented with acutely scattered brain infarction by artery-to-artery embolism due to IA stenosis. Endovascular treatment for symptomatic IA stenosis was planned to prevent recurrent attacks. Endovascular stenting for IA stenosis via the right femoral artery approach was performed under simultaneous distal balloon protection of the right internal carotid artery (ICA) and vertebral artery (VA) via the right brachial artery approach. Successful treatment of symptomatic IA stenosis was achieved with no complications. The technique with simultaneous distal balloon protection of the ICA and VA provided excellent cerebral protection in stenting of IA stenosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Guimaraes M, Muhlert MK, Enterkin J, Schönholz C (2010) Can we provide complete cerebral protection during innominate artery stenting? J Endovasc Ther 17:657–659

    Article  PubMed  Google Scholar 

  2. Hüttl K, Nemes B, Simonffy A, Entz L, Bérczi V (2002) Angioplasty of the innominate artery in 89 patients: experience over 19 years. Cardiovasc Intervent Radiol 25:109–114

    Article  PubMed  Google Scholar 

  3. Mordasini P, Gralla J, Do DD, Schmidli J, Keserü B, Arnold M, Fischer U, Schroth G, Brekenfeld C (2011) Percutaneous and open retrograde endovascular stenting of symptomatic high-grade innominate artery stenosis: technique and follow-up. AJNR Am J Neuroradiol 32:1726–1731

    Article  PubMed  CAS  Google Scholar 

  4. Motarjeme A (1996) Percutaneous transluminal angioplasty of supra-aortic vessels. J Endovasc Surg 3:171–181

    Article  PubMed  CAS  Google Scholar 

  5. Paukovits TM, Lukács L, Bérczi V, Hirschberg K, Nemes B, Hüttl K (2010) Percutaneous endovascular treatment of innominate artery lesions: a single-centre experience on 77 lesions. Eur J Vasc Endovasc Surg 40:35–43

    Article  PubMed  CAS  Google Scholar 

  6. Peterson BG, Resnick SA, Morasch MD, Hassoun HT, Eskandari MK (2006) Aortic arch vessel stenting: a single-center experience using cerebral protection. Arch Surg 141:560–563

    Article  PubMed  Google Scholar 

  7. Ryer EJ, Oderich GS (2010) Two-wire (0.014 & 0.018-in) technique to facilitate innominate artery stenting under embolic protection. J Endovasc Ther 17:652–656

    Article  PubMed  Google Scholar 

  8. Sharma S, Kaul U, Rajani M (1991) Identifying high-risk patients for percutaneous transluminal angioplasty of subclavian and innominate arteries. Acta Radiol 32:381–385

    Article  PubMed  CAS  Google Scholar 

  9. Stiefel MF, Park MS, McDougall CG, Albuquerque FC (2010) Endovascular treatment of innominate artery occlusion with simultaneous vertebral and carotid artery distal protection: case report. Neurosurgery 66:E843–E844

    Article  PubMed  Google Scholar 

  10. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, Bajwa TK, Whitlow P, Strickman NE, Jaff MR, Popma JJ, Snead DB, Cutlip DE, Firth BG, Ouriel K (2004) Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med 351:1493–1501

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shigeyuki Sakamoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sakamoto, S., Kiura, Y., Kajihara, Y. et al. Endovascular stenting of symptomatic innominate artery stenosis under distal balloon protection of the internal carotid and vertebral artery for cerebral protection: a technical case report. Acta Neurochir 155, 277–280 (2013). https://doi.org/10.1007/s00701-012-1586-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-012-1586-8

Keywords

Navigation