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The modified 'no touch' technique in the antegrade endovascular approach for left common carotid artery ostial stenosis stenting.

Abstract：

BACKGROUND:Open surgery and the retrograde endovascular approach via the distal left common carotid artery (LCCA) have some limitations in LCCA ostial stenosis treatment. The 'no touch' technique used in the renal artery was modified for this situation. METHODS:Fifteen selective LCCA stenosis patients were treated by the modified 'no touch' technique in the antegrade endovascular approach from March 2013 to March 2016. Thirteen underwent the transfemoral approach and the other two had the transbrachial approach due to a 'bovine aortic arch'. Distal embolic protection devices were used in all cases. Follow-up included a neurological examination, carotid duplex scan, and office interview. Mean follow-up time was 18.2±11.5 months. RESULTS:The initial technical success rate was 100%. The average procedure time was 84.0±16.3 min. There were no procedure-related deaths. No clinical neurological complications occurred during the in-hospital stay. No incidence of death or major stroke occurred during the follow-up period; 6.7% (1/15) of patients had a contralateral minor stroke, 66.7% (4/6) of symptomatic patients were relieved of initial symptoms, and the rest showed improvement. No patient developed new ipsilateral neurological symptoms and no in-stent restenosis occurred during the follow-up period. These results were confirmed by ultrasound. CONCLUSIONS:The modified 'no touch' antegrade endovascular technique is a feasible method for treating LCCA ostial lesions with a satisfactory initial success rate, acceptable procedure time, and comparable mid- and long-term results. This technique could be considered as a complementary option for LCCA ostial stenosis in addition to open surgery and the retrograde endovascular approach.

journal_name

J Neurointerv Surg

journal_title

Journal of neurointerventional surgery

authors

Tang X,Long WA,Hu C,Tang F,Wang Q,Li L

doi

10.1136/neurintsurg-2016-012544

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

137-141

issue

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2016-012544

journal_volume

pub_type

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The modified 'no touch' technique in the antegrade endovascular approach for left common carotid artery ostial stenosis stenting.