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Related Experiment Videos

Transaxillary carotid stenting: technical case report.

Huan Wang1, James L Swischuk, Kenneth Fraser

  • 1Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA.

Neurosurgery
|March 30, 2005
PubMed
Summary

Transaxillary carotid stenting is a safe alternative for patients unsuitable for transfemoral access. Ultrasound guidance ensures successful puncture and stent deployment in complex cases.

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Area of Science:

  • Vascular Surgery
  • Interventional Neuroradiology
  • Endovascular Neurointervention

Background:

  • Endovascular neurointerventions, including angioplasty and stenting of carotid arteries, are increasingly routine.
  • Alternative access techniques are crucial when the standard transfemoral approach is contraindicated or challenging.

Observation:

  • A 77-year-old male presented with severe (80%) left internal carotid artery stenosis.
  • Due to advanced age and comorbidities, general anesthesia posed high risks, necessitating an alternative approach.
  • An axillary bifemoral bypass graft precluded standard transfemoral access, leading to the selection of a transaxillary approach.

Findings:

  • The left axillary artery was accessed using ultrasound guidance.
  • A 7-French guiding sheath was advanced to the mid left common carotid artery.

Related Experiment Videos

  • Two stents were successfully deployed across the stenosis, achieving a satisfactory angiographic result.

    • Implications:

    • The transaxillary approach is a viable alternative for carotid stenting when transfemoral access is not feasible.
    • Ultrasound guidance enhances the safety and technical success of the transaxillary approach.
    • This technique expands endovascular treatment options for complex carotid artery disease.