Kamamoto Dai, Takahashi Shoko, Inoue Satoshi, Katayama Masateru, Suga Sadao
Department of Neurosurgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan.
Department of Neurology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan.
J Neuroendovasc Ther. 2022;16(9):481-485. doi: 10.5797/jnet.tn.2022-0005. Epub 2022 Jun 18.
The Mo.Ma Ultra is an embolic protection device used in carotid artery stenting (CAS). In cases of left internal carotid artery stenosis (ICS) in which the common carotid artery (CCA) branches off the aortic arch at a steep angle, insertion of the Mo.Ma Ultra into the CCA is sometimes difficult. We introduce a "buddy catheter technique" that helps guide the Mo.Ma Ultra into the CCA, with an additional 4 Fr catheter into the external carotid artery.
An 84-year-old man with left ICS whose CCA also branched off the aortic arch at a steep angle also underwent CAS. The "buddy catheter technique" was used, and the Mo.Ma Ultra was inserted smoothly. The buddy catheter technique displaces the left CCA upward. Displacement straightens the vessels anatomically, and the ledge effect can be prevented by aligning the course of the vessels with the wire. Nevertheless, this technique requires bilateral femoral puncture, and so, complications can occur.
The buddy catheter technique may be considered in cases in which the left CCA branches off the aortic arch at a steep angle.
Mo.Ma Ultra是一种用于颈动脉支架置入术（CAS）的栓塞保护装置。在左颈内动脉狭窄（ICS）且颈总动脉（CCA）从主动脉弓以陡峭角度分支的情况下，将Mo.Ma Ultra插入CCA有时会很困难。我们介绍一种“伙伴导管技术”，该技术通过额外插入一根4F导管至颈外动脉，帮助将Mo.Ma Ultra引导至CCA。
一名84岁患有左ICS且CCA也从主动脉弓以陡峭角度分支的男性接受了CAS。使用了“伙伴导管技术”，Mo.Ma Ultra顺利插入。伙伴导管技术使左CCA向上移位。移位在解剖学上使血管变直，并且通过使血管走行与导丝对齐可防止凸缘效应。然而，该技术需要双侧股动脉穿刺，因此可能会发生并发症。
在左CCA从主动脉弓以陡峭角度分支的情况下，可考虑使用伙伴导管技术。
