Kuo Ming-Jen, Chen Po-Lin, Shih Chun-Che, Chen I-Ming
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Interact Cardiovasc Thorac Surg. 2018 Jan 1;26(1):8-10. doi: 10.1093/icvts/ivx273.
In patients with severe carotid artery stenosis, the anatomy of their Type III aortic arch increases the difficulty and complication rates during carotid artery stenting because of its tortuosity and sharp angulation for cannulation as well as the unstable support of the guidewire for shuttle sheath delivery.
We demonstrate a novel technique to overcome these challenges, namely the creation of stable innominate artery access by inserting a through-and-through body floss wire from the right brachial artery to the femoral artery.
We successfully performed right carotid artery stenting in 3 patients with Type III arch anatomy. All patients received regular outpatient follow-up uneventfully for more than 1 year.
This facilitates the procedure of the right carotid artery stenting in patients with Type III aortic arch.
在严重颈动脉狭窄患者中，Ⅲ型主动脉弓的解剖结构因其迂曲、插管时角度锐利以及导丝对穿梭鞘输送的支撑不稳定，增加了颈动脉支架置入术的难度和并发症发生率。
我们展示了一种克服这些挑战的新技术，即通过从右肱动脉插入一根贯穿身体的牙线至股动脉来建立稳定的无名动脉通路。
我们成功地为3例Ⅲ型主动脉弓解剖结构的患者进行了右侧颈动脉支架置入术。所有患者均接受了超过1年的定期门诊随访，过程顺利。
这有利于Ⅲ型主动脉弓患者进行右侧颈动脉支架置入术。
