Novel access technique facilitating carotid artery stenting

Carotid artery stenting (CAS) may be impossible, or associated with a high risk, in patients with severe vessel tortuosity. A novel method of catheterization of the carotid artery intended to facilitate CAS is described. It involves the placement of a microcatheter and a coronary wire through a dissected superficial temporal artery (STA), and then advanced to the ascending aorta. The wire is then snared and brought out through a sheath already placed from the common femoral artery (CFA). Thus through-and-through access from the STA to the CFA is established. The sheath is then brought over the coronary artery into the common carotid artery. Using the coronary artery as "buddy wire" the carotid artery stenting is carried out in a standard fashion. The potential benefit of this new technique is the decrease of risk of the procedures in patients with prohibiting vessel tortuosity.