Transfemoral subclavian artery stenting through a shaped guiding catheter without pull-through technique: A case report

Yasushi Ogasawara, MD; Yosuke Akamatsu, MD; Wataru Yanagihara, MD; Daigo Kojima, MD; Naoto Kimura, MD; Hiroshi Kashimura, MD; Yoshitaka Kubo, MD; Kuniaki Ogasawara, MD

Radiology Case Reports (Oct 2022)

Transfemoral subclavian artery stenting through a shaped guiding catheter without pull-through technique: A case report

Yasushi Ogasawara, MD,
Yosuke Akamatsu, MD,
Wataru Yanagihara, MD,
Daigo Kojima, MD,
Naoto Kimura, MD,
Hiroshi Kashimura, MD,
Yoshitaka Kubo, MD,
Kuniaki Ogasawara, MD

Affiliations

Yasushi Ogasawara, MD: Department of Neurosurgery, Iwate Medical University School of Medicine, 2-1-1 Yahaba, Iwate, 028-3694, Japan
Yosuke Akamatsu, MD: Department of Neurosurgery, Iwate Medical University School of Medicine, 2-1-1 Yahaba, Iwate, 028-3694, Japan; Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan; Corresponding author.
Wataru Yanagihara, MD: Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan
Daigo Kojima, MD: Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan
Naoto Kimura, MD: Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan
Hiroshi Kashimura, MD: Department of Neurosurgery, Iwate Medical University School of Medicine, 2-1-1 Yahaba, Iwate, 028-3694, Japan
Yoshitaka Kubo, MD: Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan
Kuniaki Ogasawara, MD: Department of Neurosurgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, Japan

Journal volume & issue: Vol. 17, no. 10
pp. 3461 – 3465

Abstract

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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.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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