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Left Internal Carotid Artery Occlusion with Progressive Right Internal Carotid Artery Stenosis

Case of the month: November 2017

This 18 minutes didactic recorded procedure concerns a 68 years old male  with coronary insufficiency and carotid lesions. He presents an occluded left internal carotid artery associated with a severe ulcerated worsening right internal carotid stenosis.
This complex stenosis was treated by new micromesh carotid stent under carotid protection by filter . Watch now this informative procedure on how to treat patients with multiple carotid lesions.

Step-by-Step Procedure

  • Femoral access for carotid angioplasty
  • Common carotid access in tortuous aorta
  • Analysis of carotid lesion by selective angiography
  • Placement of filter as embolic protecting device
  • Pre-dilatation and artery preparation before carotid artery stenting
  • Placement of braided micromesh stent Roadsaver
  • Post Stenting dilatation and analysis of results
  • Filter retrieval and evaluation of carotid circulation  

Learning points

  • How to access from groin the brachio-cephalic trunk in a tortuous aorta
  • The use of two guidewires to access common carotid
  • Placement of filter in a tortuous carotid artery
  • Predilatation and preparation of carotid lesion before stenting
  • Accurate placement of new micromesh carotid stent
  • Cardiac monitoring during carotid stenting

Bibliography

 



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