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Updated: Aug 18, 2026
Training a Sophisticated Microsurgical Technique: Interposition of External Jugular Vein Graft in the Common Carotid Artery in Rats
Published on: November 11, 2012
Modified technique for using vascular sheaths in carotid artery stent placement
M H Wholey1, B Toursarkissian, S Bailey
1Department of Radiology, University of Texas Health Science Center at San Antonio, 78284, USA. wholey@uthscsa.edu
Purpose:
To report a technical modification that will prevent sheath kinking in acutely angled vessels during carotid stent placement.
Technique:
If a long vascular sheath kinks when engaging an acutely angled common carotid or innominate artery, the sheath is pulled caudally approximately 2 cm while a 0.014-inch guidewire, supported by a coronary balloon catheter, is advanced toward the internal carotid artery (ICA). Alternatively, to avoid kinking, the original 0.035-inch super stiff wire is maintained within the sheath until the 0.014-inch wire and coronary balloon have exited the sheath's distal tip.
Conclusions:
If an aortic arch is tortuous and the angle of the common carotid artery is unfavorable, a guiding catheter is preferable to a long vascular sheath for accessing the ICA during carotid stent procedures.
