Sievert H, Ensslen R, Fach A, Merle H, Rubel C, Spies H, Sultan N, Beykirch K F, Theis R, Schultze H J
Cardioangiologisches Centrum Bethanien, Frankfurt, Germany.
Cathet Cardiovasc Diagn. 1996 Dec;39(4):421-3. doi: 10.1002/(SICI)1097-0304(199612)39:4<421::AID-CCD22>3.0.CO;2-E.
One possible problem in internal carotid angioplasty is inaccessibility of the lesion due to elongation of the aortic arch, the brachiocephalic trunk, or the carotid artery itself. A new approach to performing angioplasty of the right or left internal carotid artery utilizing the brachial artery was used after failure of the transfemoral approach in 5 lesions (4 patients). The common carotid artery was cannulated with performed 5F catheters. Angioplasty was performed with a conventional balloon dilatation catheter. If required, a Wall stent was implanted to optimize the angiographic result. After failure of the conventional transfemoral technique, the brachial technique permitted successful angioplasty of the ipsilateral internal carotid artery in 4 lesions and the contralateral internal carotid artery in 1 lesion. In 1 patient, a stent was implanted. No complications occurred. The mean stenosis diameter decreased from 77.8 +/- 6.3% to 17.8 +/- 9.1%. Doppler sonography performed 4-6 months later showed no restenosis. The brachial artery approach seems to be a suitable alternative to the femoral technique.
颈内动脉血管成形术的一个潜在问题是，由于主动脉弓、头臂干或颈动脉本身的延长，病变难以触及。在5例病变（4例患者）经股动脉入路失败后，采用了一种利用肱动脉对右侧或左侧颈内动脉进行血管成形术的新方法。使用5F导管对颈总动脉进行插管。使用传统的球囊扩张导管进行血管成形术。如有需要，植入Wall支架以优化血管造影结果。在传统经股动脉技术失败后，肱动脉技术使4例病变的同侧颈内动脉和1例病变的对侧颈内动脉成功进行了血管成形术。1例患者植入了支架。未发生并发症。平均狭窄直径从77.8±6.3%降至17.8±9.1%。4至6个月后进行的多普勒超声检查显示无再狭窄。肱动脉入路似乎是股动脉技术的合适替代方法。
