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Updated: Aug 13, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Transseptal approach for stent implantation in right internal carotid artery stenosis
1Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Shinchon-Dong 134, Seodaemun-Ku, CPO Box 8044, Seoul, Korea.
Insights
Transseptal approach carotid artery stenting successfully treated severe stenosis in a complex case. This technique offers an alternative for challenging anatomies, preventing strokes.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Neurology
Background:
- Carotid artery stenting (CAS) is a key stroke prevention strategy for significant carotid artery stenosis.
- Complex aortic arch anatomy and tortuosity can impede standard femoral access for CAS.
Observation:
- A patient presented with right internal carotid artery stenosis and severe triple-vessel coronary artery disease, including left main stenosis.
- Standard femoral artery access was not feasible due to a sharply angled right brachiocephalic artery origin from a tortuous aortic arch.
Findings:
- Successful carotid artery stenting was achieved using a transseptal approach.
- This approach facilitated wire advancement into the right common carotid artery, overcoming anatomical challenges.
Implications:
- The transseptal approach provides a viable alternative for CAS in patients with difficult aortic arch anatomy.
- This technique expands treatment options for stroke prevention in complex cardiovascular cases.
Abstract:
Carotid artery stenting is emerging as an effective measure to prevent strokes in patients with significant carotid artery stenosis. We report a case of right internal carotid artery stenosis in which we used a transseptal approach for successful carotid artery stenting. This patient had concomitant stenosis at all three coronary arteries, including the left main coronary artery. A transseptal approach was adopted due to the sharply angled take-off of the right brachiocephalic artery from the tortuous aortic arch, where advancement of an extra-stiff wire into the right common carotid artery was not possible by a femoral artery approach.
