Vertebral Artery Origin Stent Placement Using the Dual Lumen Qureshi-Jiao Guidecatheter

We report the first experience with a new dual lumen guide catheter with lumen A with curved tip designed for delivery of stent and angioplasty catheters and lumen B with side exit for coaxial placement of stiff 0.014 inch wire.

We prospectively determined technical success, intended procedure (stent delivery at target lesion and a final residual stenosis <30%) completed without a need for a different catheter, and technical ease, intended procedure completed without ≥3 unsuccessful attempts in patients with symptomatic vertebral artery origin stenosis. Vertebral artery origin was classified as type A if originated from ascending segment and type B if originated from an arch or horizontal segment of subclavian artery.

The mean age of the four treated patients was 66.2 years (range 64-68 years). The mean percentage of vertebral artery origin stenosis was 82.7% (range 60-92%). The origin of vertebral artery from subclavian artery was classified as type A and type B origins in two patients each. The dual lumen catheter was advanced over an exchange length of 0.035 inch glide wire in one patient and directly through transfemoral insertion in three patients. Technical success and technical ease was achieved in all four procedures. Post procedure residual stenosis was 6% (range 5-7%). The primary operator rated the performance of guide catheter as superior compared with another catheter used in such procedures.

The present study demonstrates the feasibility of performing stent placement for vertebral artery origin stenosis by using a dual lumen catheter with superior performance.