Dayton Interventional Radiology, Dayton, Ohio 45409, USA.
J Endovasc Ther. 2011 Oct;18(5):729-33. doi: 10.1583/11-3481.1.
To describe an entirely percutaneous treatment for carotid artery stenting in a type IIa aortic arch via the superficial temporal artery (STA) for through-and-through guidewire access.
The technique is demonstrated in an 83-year-old man status post left carotid endarterectomy 3 months prior who presented with 2.5 hours of confusion and dysphasia following diagnostic carotid arteriography. The patient was known to have a type IIa bovine aortic arch and a severe 70% stenosis of the left internal carotid artery. The patient was referred for carotid artery stenting by his vascular surgeon. Due to the bovine arch, a percutaneous ultrasound-guided approach via the STA for through-and-through wire access facilitated carotid artery stenting from the right common femoral artery. The procedure was successful, and follow-up duplex ultrasound confirmed patency of the STA the next day.
A percutaneous ultrasound-guided STA access can help facilitate transfemoral carotid artery stenting in an otherwise difficult type IIa aortic arch setting.
通过经颅浅动脉（STA）为贯穿导丝入路，描述一种用于治疗 IIa 型主动脉弓颈动脉支架的完全经皮治疗方法。
该技术在一名 83 岁男性中进行了演示，该男性在 3 个月前进行了左侧颈动脉内膜切除术，因诊断性颈动脉血管造影后出现 2.5 小时的意识模糊和言语障碍而就诊。该患者已知有 IIa 型牛型主动脉弓和左侧颈内动脉严重的 70%狭窄。他的血管外科医生建议进行颈动脉支架置入术。由于牛型弓，经皮超声引导下的 STA 贯穿导丝入路有助于从右侧股总动脉进行颈动脉支架置入术。该手术成功，次日的随访双功能超声检查确认了 STA 的通畅性。
经皮超声引导的 STA 入路可有助于在其他困难的 IIa 型主动脉弓环境下进行经股动脉颈动脉支架置入术。
