Related Experiment Video
Updated: Mar 28, 2026
Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Percutaneous carotid artery access in infants < 3 months of age
Swati Choudhry1, David Balzer1, Joshua Murphy1
1Division of Pediatric Cardiology, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri.
Insights
Percutaneous carotid artery (CA) access is safe and feasible in infants younger than 3 months for cardiac catheterization. This minimally invasive approach demonstrated successful access with no major complications and preserved vascular patency.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Vascular Access Techniques
Background:
- Surgical cut down for carotid artery (CA) access in infants with congenital heart disease is established.
- Limited data exists on percutaneous CA access in infants under 3 months old.
Purpose of the Study:
- To evaluate the safety and feasibility of percutaneous CA access in infants younger than 3 months.
- To assess procedural success rates and complications associated with this technique.
Main Methods:
- Retrospective review of 18 infants (<3 months) undergoing cardiac catheterization via percutaneous CA approach (2012-2015).
- Procedures included PDA stenting, BT shunt stenting, balloon aortic valvuloplasty, and coarctation angioplasty.
- Ultrasound-guided Doppler needle used for CA access; sheath sizes ranged from 4 Fr to 6 Fr.
Main Results:
- Successful percutaneous CA access achieved in all 20 procedures (16 right CA, 4 left CA).
- No major procedural complications; minor complications included hypotension and ductal spasm.
- Two cases of CA pseudoaneurysm occurred post-procedure, requiring surgical repair; no arterial occlusions noted.
Conclusions:
- Percutaneous CA access is a safe and feasible option for infants <3 months undergoing cardiac catheterization.
- The technique is associated with preserved vascular patency and no neurological adverse events.
- This approach offers a viable alternative to surgical cut down in this vulnerable population.
Background:
Carotid artery access in infants with congenital heart disease undergoing cardiac catheterization via a surgical cut down has been well described. There is a paucity of information regarding percutaneous carotid artery (CA) access in infants <3 months.
Methods:
A retrospective review of infants <3 months of age undergoing cardiac catheterization via percutaneous CA approach was performed after IRB approval. Between January 2012 and May 2015, 18 patients underwent 20 procedures; median age 13 days (2-77); median weight 3.3 kg (1.6-5). Procedures performed were patent ductus arteriosus (PDA) stenting (8), modified blalock taussig (BT) shunt stenting (3), balloon aortic valvuloplasty (6), and balloon angioplasty of coarctation (3).
Results:
Percutaneous access was obtained with a Doppler needle under ultrasound guidance into the right (16) and left CA (4). Sheath size used was 4 Fr (17), 5 Fr (2), and 6 Fr (1). Median time to sheath insertion was 6.5 min (2-20). Percutaneous access was obtained successfully in all cases. There were no major procedural complications. There were two minor complications; hypotension, and ductal spasm. Hemostasis was achieved by manual compression; median time was 14.5 min (8-36). There were two post-procedural complications involving development of CA pseudo aneurysms that were repaired surgically. Post-procedure CA patency was documented by angiography (3), MRA (3), or vascular ultrasound (14). There were no documented arterial occlusions.
Conclusion:
Our experience suggests that percutaneous CA access in infants <3 months of age is safe and feasible with preserved vascular patency and no neurological adverse events.
