Vertebral artery origin stenting with buddy wire technique in tortuous subclavian artery

Area of Science:

• Vascular Surgery
• Interventional Neuroradiology
• Cardiovascular Interventions

Background:

• Catheterization of tortuous and atherosclerotic vessels poses significant technical challenges.
• These challenges are linked to an increased risk of vascular complications.
• Specifically, guiding catheter placement in the tortuous subclavian artery for vertebral artery origin stenting is difficult, often resulting in poor backup support.

Purpose of the Study:

• To describe an innovative technique for managing guiding catheter placement in challenging anatomies.
• To facilitate vertebral artery origin stenting in patients with severe aortic arch and subclavian artery tortuosity.
• To improve procedural success and potentially reduce vascular complications in complex neurointerventional cases.

Main Methods:

• A technique utilizing a 'buddy wire' was employed to stabilize the guiding catheter.
• This method was applied during vertebral artery origin stenting procedures.
• The technique addresses difficulties associated with severe tortuosity of the aortic arch and proximal subclavian artery.

Main Results:

• The buddy wire technique successfully stabilized the guiding catheter in the desired position.
• This stabilization enabled the performance of stenting for vertebral artery origin stenosis.
• The described method offers a viable solution for complex cases previously deemed technically challenging.

Conclusions:

• The buddy wire technique is an effective method for improving guiding catheter stability in tortuous vessels.
• This technique facilitates successful vertebral artery origin stenting in challenging anatomies.
• It represents a valuable addition to the interventional neuroradiologist's armamentarium for complex vascular interventions.