Percutaneous Common Carotid Artery Access for Pediatric Interventional Cardiac Catheterization

Justino, Henri; Petit, Christopher J.

doi:10.1161/circinterventions.115.003003

Cited by 67 publications

(67 citation statements)

References 30 publications

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“…In this series, recanalization of atretic renal arteries was possible in two children, a 10‐week‐old weighing 3.4 kg, and a 2‐year‐old weighing 11.7 kg (Figure ). In the younger infant, femoral arterial approach provided limited access to the angulated renal arteries requiring conversion to a percutaneous carotid approach which provides a straight catheter course and has been shown to be a safe alternative . The recanalized renal artery has remained patent, although requiring interval repeat angioplasties with gradually larger balloons.…”

Section: Resultsmentioning

confidence: 99%

Interventions in children with renovascular hypertension: A 27-year retrospective single-center experience

Agrawal

Moodie

Qureshi

et al. 2018

Congenital Heart Disease

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Section: Resultsmentioning

confidence: 99%

Interventions in children with renovascular hypertension: A 27-year retrospective single-center experience

Agrawal

Moodie

Qureshi

et al. 2018

Congenital Heart Disease

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“…Hence, CA and even axillary artery (AA) access have been employed to place the PDA stent in some infants with this PDA anatomy. There are limited studies describing outcomes following surgical‐assisted or percutaneous CA access for neonatal interventions . These studies suggest that percutaneous CA is a safe alternative to traditional FA access, with a higher arterial patency rate post‐procedure compared with contemporary results from the FA .…”

Section: Introductionmentioning

confidence: 99%

Use of carotid and axillary artery approach for stenting the patent ductus arteriosus in infants with ductal‐dependent pulmonary blood flow: A multicenter study from the congenital catheterization research collaborative

Bauser‐Heaton

Qureshi

Goldstein

et al. 2019

Cathet Cardio Intervent

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Background Carotid artery (CA) and axillary artery (AA) access are increasingly used for transcatheter stenting of the patent ductus arteriosus (PDA), although reports are limited. Methods The Congenital Catheterization Research Collaborative (CCRC) reviewed multicenter data from infants who underwent PDA stenting via the CA or AA approach from 2008 to 2017, and compared outcomes to those of infants undergoing PDA stenting via the femoral artery (FA) approach. Post‐procedure ultrasound (US) imaging was reviewed. Results Forty‐nine infants underwent PDA stenting from the CA (n = 43) or AA (n = 6) approach, compared with 55 infants who underwent PDA stenting from the FA approach. The PDA was the sole pulmonary blood flow (PBF) source in 61% of infants in the CA/AA cohort, compared with 33% of the FA cohort (p < .01). Ductal tortuosity for CA/AA cohort was Type I (straight) in 10 (20%), Type II (one turn) in 17 (35%), and Type III (multiple turns) in 22 (45%) infants and reflected a greater degree of tortuosity when compared to the FA cohort (p < .01). In 17 infants with CA/AA approach, the “flip technique” was used, and was associated with shorter procedure times for highly tortuous PDA (Type III) patients. Rates of procedural complications were similar across access sites. Most common complications were access site injury (thrombus or bleeding) and stent malposition. No complications were specifically related to the “flip technique.” Conclusions Use of CA and AA approach for PDA stenting was found to be more commonly employed in sole source PBF and highly tortuous PDAs. Procedural modifications such as the “flip technique” may lead to shorter procedure times. CA and AA approaches are associated with a similar burden of procedural or late complications. Post‐procedural surveillance of the CA and AA is suggested, given the incidence of vascular findings on US.

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“…For PDAs that originate from the underside of the aortic arch (and some from the head/neck vessels), percutaneous axillary artery or common carotid artery access facilitates a direct and straight trajectory which allows for easier maneuverability of guidewires/stent systems. While previously axillary artery or common carotid artery access was performed via surgical cut down techniques, percutaneous axillary and percutaneous carotid artery access for PDA stenting has been shown to be safe and effective . We perform percutaneous axillary (Figure ) and percutaneous carotid artery (Figure ) access for these procedures with ultrasound guidance to ensure an isolated anterior wall puncture.…”

Section: Interventional Proceduresmentioning

confidence: 99%

Stenting of the ductus arteriosus for ductal-dependent pulmonary blood flow-current techniques and procedural considerations

Aggarwal

Petit

Glatz

et al. 2019

Congenital Heart Disease

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The use of prostaglandin‐E1 immediately after birth and subsequent surgical creation of the modified Blalock‐Taussig shunt (BTS) shunt have remarkably improved the prognosis and survival of children with congenital heart disease and ductal‐dependent pulmonary blood flow (PBF). Despite the advancement in surgical techniques, bypass strategies, and postoperative management, significant morbidity and mortality after BTS still remain. Patent ductus arteriosus stenting has been shown to be as an acceptable alternative to BTS placement in select infants with ductal‐dependent PBF. Newer procedural techniques and equipment, along with operator experience have all contributed to procedural refinement associated with improved outcomes over the recent years. In this article, we review the procedural and periprocedural details, with an emphasis on recent advances of this procedure.

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Percutaneous Common Carotid Artery Access for Pediatric Interventional Cardiac Catheterization

Cited by 67 publications

References 30 publications

Interventions in children with renovascular hypertension: A 27-year retrospective single-center experience

Interventions in children with renovascular hypertension: A 27-year retrospective single-center experience

Use of carotid and axillary artery approach for stenting the patent ductus arteriosus in infants with ductal‐dependent pulmonary blood flow: A multicenter study from the congenital catheterization research collaborative

Stenting of the ductus arteriosus for ductal-dependent pulmonary blood flow-current techniques and procedural considerations

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