The concept of an anatomy related individual arterial access: lowering technical and clinical complications with transradial access in bovine- and type-III aortic arch carotid artery stenting

Dahm, Johannes B.; Buuren, Frank van; Hansen, C.; Becker, J.; Wolpers, H. G.

doi:10.1024/0301-1526/a000150

Cited by 23 publications

(19 citation statements)

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“…A few small studies evaluated the safety and efficacy of carotid artery stenting via the TR approach . These reports confirm the technical challenge when approaching the common carotid artery from either subclavian artery, due to the acute angle between the two.…”

Section: Trpi – Technical Considerationsmentioning

confidence: 80%

Transradial access for peripheral vascular interventions

Staniloae

Korabathina

Coppola

2013

Cathet Cardio Intervent

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Section: Trpi – Technical Considerationsmentioning

confidence: 80%

Transradial access for peripheral vascular interventions

Staniloae

Korabathina

Coppola

2013

Cathet Cardio Intervent

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“…On the other hand, the right brachial approach for left CAS in a bovine-type aortic arch or the right brachial approach in a type-III aortic arch for CAS appears to be safe and technically feasible. 12–14) When the anatomical characteristics of a right-sided aortic arch limits navigation of a guiding catheter into the CCA from the trans-femoral access, placement of a guiding catheter to the CCA from the right brachial access should be considered as an alternative. …”

Section: Discussionmentioning

confidence: 99%

Carotid Artery Stenting in Right-sided Aortic Arch: A Case Report

Ohtani

Yamazaki

Ohtaki

et al. 2016

NMC Case Report Journal

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The present report describes a patient with pseudo-occlusion of the left internal carotid artery accompanied by aortic anomalies consisting of right-sided aortic arch with aberrant left subclavian artery arising from Kommerell’s diverticulum. Initial attempt of carotid artery stenting via the trans-femoral approach was unsuccessful because of low origin of the left common carotid artery. Therefore, carotid artery stenting (CAS) via the trans-brachial approach was successfully performed with distal balloon protection. Eight months later, the patient presented with restenosis of the left internal carotid artery, and CAS via the trans-brachial approach was performed again. CAS via the trans-brachial approach should be considered when standard femoral access is relatively contraindicated due to aortic anomalies consisting of a right-sided aortic arch.

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“…The steep arch is hard to manoeuvre and during cerebral aneurysm catheterisation, emboli dislodgment may occur due to manipulation within a highly stenotic vessel [8]. The common carotid artery is usually accessed via the femoral artery approach, however in cases of a complex arch the brachial or radial artery may be preferred [9].…”

Section: Tablementioning

confidence: 99%

Anatomical and radiological evaluation of the variation in the branching patterns and morphology of the aortic arch in the irish population- A morphometric study

Boyle¹,

Al-Modhefer²,

Worthington³

2019

Int J Anat Var

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Boyle OK. Anatomical and radiological evaluation of the variation in the branching patterns and morphology of the aortic arch in the irish population-A morphometric study. Int J Anat Var. 2019;12(4): 40-45.Introduction: Anatomical variations of the aortic arch are clinically significant for diagnostic and surgical procedures in the mediastinum. Our objective was to determine the arch morphology and incidence of variant branching patterns in both a cadaveric and patient population.Materials and Methods: 194 CT scans were retrospectively analysed for branching variations and arch type. 18 cadavers were dissected with variations noted.Results: Analysis of scans revealed normal branching in 77.32%, bovine arch pattern in 14.43%, direct origin of the left vertebral artery in 7.73% and a bovine arch with direct origin of the left vertebral artery in 0.52%. A significant correlation (p<0.0001) was found between arch type and age, with the mean age of a type 1 arch 51.1 years, type 2 arch 60.7 years, and type 3 arch 70.7 years. Direct origin of the left vertebral artery was found in one cadaver.Conclusion: Correlation between arch type and age strengthens the concept of age-related unfolding of the aortic arch. A detailed understanding of the branching variations of the arch is important in the disciplines of anatomy, radiology and cardiothoracic surgery. characteristics in both a cadaveric and patient population. Through the use of dissection and computed tomography, clinically relevant morphometric data was gathered which can be applied to both the diagnostic and surgical field.

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The concept of an anatomy related individual arterial access: lowering technical and clinical complications with transradial access in bovine- and type-III aortic arch carotid artery stenting

Abstract: CAS using the right transradial approach for left CAS in bovine-type aortic arch or the right transradial approach in type-III aortic arch for right CAS appears to be safe and technically feasible.

Cited by 23 publications

References 0 publications

Transradial access for peripheral vascular interventions

Transradial access for peripheral vascular interventions

Carotid Artery Stenting in Right-sided Aortic Arch: A Case Report

Anatomical and radiological evaluation of the variation in the branching patterns and morphology of the aortic arch in the irish population- A morphometric study

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