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Transfemoral subclavian artery stenting through a shaped guiding catheter without pull-through technique: A case report
Authors:Yasushi Ogasawara  Yosuke Akamatsu  Wataru Yanagihara  Daigo Kojima  Naoto Kimura  Hiroshi Kashimura  Yoshitaka Kubo  Kuniaki Ogasawara
Affiliation:aDepartment of Neurosurgery, Iwate Medical University School of Medicine, 2-1-1 Yahaba, Iwate, 028-3694, Japan;bDepartment of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan;cDepartment of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan
Abstract:Transfemoral subclavian artery stenting can be challenging unless the placement of the guiding catheter is secured. Herein, we present a patient with subclavian artery stenosis treated with endovascular stenting using a shaped guiding catheter. A 79-year-old woman was admitted to our department because of a cold sensation and numbness of her left arm. Computed tomography revealed stenosis of the left subclavian artery (SA), located just proximal to the ostium of the left vertebral artery (VA). Doppler ultrasound showed reverse flow in the left VA. We planned to stent for the SA stenosis under the balloon protection of the left VA. The balloon protection device was easily navigated into the left VA through brachial access. After that, a self-expandable stent was successfully placed from just proximal to the VA origin to the ostium of the SA using a highly stable shaped guiding catheter. The patient recovered from the symptoms and was discharged 4 days after the procedure. The high stability of the shaped guiding catheter is advantageous during endovascular treatment of the subclavian artery.
Keywords:Subclavian artery stenosis   Transfemoral   Shaped guiding catheter   Pull-through
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