open access

Ahead of print
Case Reports
Published online: 2018-09-07
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"Modified No-touch technique using floating wire"- a novel technique of Unprotected Carotid Artery Stenting for aorto-ostial lesion.

Santosh Kumar Sinha, Umeshwar Pandey, Vinay Krishna, Mahmodulla Razi, Kumar Himanshu, Lokendra Rekwaal
DOI: 10.5603/FC.a2018.0084

open access

Ahead of print
Case Reports
Published online: 2018-09-07

Abstract

Takayasu arteritis (TA) is chronic inflammatory large vessel vasculitis where aorta and its main branches bear the maximum burden. Here, we report a case of 23-yr-old hypertensive male that had an episode of transient ischemic attack (TIA) three months back. He was diagnosed with type I Takayasu’s arteritis (TA) showing long segment osteo-proximal lesion of right common carotid artery (RCC) with near total occlusion, along with lesion involving bifurcation and proximal part of internal carotid artery having similar degree of severity on computed tomographic angiography of aorta. It was successfully stented with two overlapping 6x19, and 6x18 mm Herculink stent (Abott Vascular, USA) distally at 12 atm pressure while aorto-ostial lesion was stented using 7x19, and 7x18 mm overlapping Herculink stents at 14 atm pressure achieving excellent results with no residual stenosis. Carotid artery stenting (CAS) was unprotected as no embolic protection device was used, and aorto-ostial lesion was stented keeping a floating wire in subclavian artery as a modification of no touch technique. At 4-year follow up, computed tomographic imaging revealed well apposed stents with excellent patency.

Abstract

Takayasu arteritis (TA) is chronic inflammatory large vessel vasculitis where aorta and its main branches bear the maximum burden. Here, we report a case of 23-yr-old hypertensive male that had an episode of transient ischemic attack (TIA) three months back. He was diagnosed with type I Takayasu’s arteritis (TA) showing long segment osteo-proximal lesion of right common carotid artery (RCC) with near total occlusion, along with lesion involving bifurcation and proximal part of internal carotid artery having similar degree of severity on computed tomographic angiography of aorta. It was successfully stented with two overlapping 6x19, and 6x18 mm Herculink stent (Abott Vascular, USA) distally at 12 atm pressure while aorto-ostial lesion was stented using 7x19, and 7x18 mm overlapping Herculink stents at 14 atm pressure achieving excellent results with no residual stenosis. Carotid artery stenting (CAS) was unprotected as no embolic protection device was used, and aorto-ostial lesion was stented keeping a floating wire in subclavian artery as a modification of no touch technique. At 4-year follow up, computed tomographic imaging revealed well apposed stents with excellent patency.

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Keywords

Carotid Artery Stenting; Carotid Endarterectomy; Takayasu Arteritis; Transient Ischemic Attack.

About this article
Title

"Modified No-touch technique using floating wire"- a novel technique of Unprotected Carotid Artery Stenting for aorto-ostial lesion.

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2018-09-07

DOI

10.5603/FC.a2018.0084

Keywords

Carotid Artery Stenting
Carotid Endarterectomy
Takayasu Arteritis
Transient Ischemic Attack.

Authors

Santosh Kumar Sinha
Umeshwar Pandey
Vinay Krishna
Mahmodulla Razi
Kumar Himanshu
Lokendra Rekwaal

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