Application of straight guiding catheter exchange assisted by double guidewire in carotid-artery stenting with circuitous approach
10.3760/cma.j.issn.1671-8925.2013.07.013
- VernacularTitle:双导丝并直管交换在入路高度迂曲颈动脉支架植入术中的应用
- Author:
Gang-Wei CHENG
1
;
Shui-Bin LI
;
Li-Min LUO
;
Kun-Yuan ZHOU
;
Qin-Hui ZHU
Author Information
1. 514031,梅州市人民医院神经内二科
- Keywords:
Balloon Dilatation;
Carotid artery;
Stent
- From:
Chinese Journal of Neuromedicine
2013;12(7):703-706
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore whether straight guiding catheter exchange assisted by double guidewire can slove the difficult problem of the guiding catheter being unable to enter the right carotid artery in patients with carotid stenosis via circuitous approach.Methods Fifteen patients with severe carotid stenosis,admitted to our hospital from August 2005 to January 2013,were chosen in our study; they were performed straight guiding catheter exchange assisted by double guidewire.Secondary carotid sinus syndrome,puncture wound,acute coronary syndrome,cerebral infarction and cerebral hemorrhage in the postprocedural period were observed; National Institutes of Health Stroke Scale (NIHSS) scores 3 and 30 days after the surgery were recorded and compared; meanwhile,modified Rankin Scale (mRS) scores 3 months after the surgery were compared.Results With the techniques of straight guiding catheter exchange assisted by double guidewire,13 patients were successfully implanted carotid artery stent among the 15 patients.Two patients had secondary carotid sinus syndrome,3 had femoral sheath around postoperative bleeding and 1 had femoral artery fistula during the 13 patients.The NIHSS scores in 1 patient decreased after the operation,but new infarction lesion was not found in the head CT.The NIHSS scores 30 days after the surgery [11 (8-13)] were significantly lower than the preoperative NIHSS scores [14(9-17)] (Z=-10.153,P-0.000).The mRS scores 3 months after the surgery was significantly improved as compared with those before surgery (U=2.079,P=-0.045).Conclusion The application of straight guiding catheter exchange assisted by double guidewire is safe and effective in the carotid-artery stenting via circuitous approach.
