New Techniques for Intracranial Stent Navigation in Patients with Tortuous Arteries.
10.3348/jkrs.2005.52.2.101
- Author:
Hyun Wook CHOI
1
;
Young Baek KOO
;
Tae Hong LEE
;
Hak Jin KIM
;
Jun Woo LEE
;
Chang Won KIM
;
Suk KIM
;
Ki Seok CHOO
;
Yeon Joo JEONG
;
Suk Hong LEE
Author Information
1. Department of Diagnostic Radiology, Pusan National University Hospital, Pusan, Korea. drcello@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Angioplasty;
Intracranial atherosclerosis;
Stents
- MeSH:
Angioplasty;
Arteries*;
Carotid Artery, Internal;
Catheters;
Humans;
Intracranial Arteriosclerosis;
Middle Cerebral Artery;
Stents*;
Vertebral Artery
- From:Journal of the Korean Radiological Society
2005;52(2):101-106
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We wanted to describe several new techniques of intracranial stenting that are helpful for navigating the stent delivery system in the tortuous carotid or vertebral arteries. MATERIALS AND METHODS: Between May 1998 and June 2004, 65 patients with 73 symptomatic, stenotic intracranial arteries (more than 50%) were successfully treated with stent-assisted angioplasty. In eleven of the total cases, the standard technique failed to navigate the stent delivery system into the objective lesion because of the tortuous path of the carotid or vertebral arteries. In these cases, several new techniques were used to overcome the vessels' tortuous path. The several new techniques were 1) the waiting method (20-30 minutes) after advancement of microwire across the lesion; 2) the double wires technique using an additional microwire; and 3) the coaxial double guiding catheters technique using an additional smaller guiding catheter. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries. RESULTS: In all difficult cases, intracranial artery stenting was performed successfully by using the several new techniques. The waiting method made smooth stent navigation possible in 5 cases, the double wire technique was successful in 4 cases and the coaxial double guiding catheter technique was successful in 2 case. There was no complication related to the new techniques. CONCLUSION: In difficult cases where the standard technique failed to navigate the stent delivery system into the objective lesion because of the vessels' tortuous path, these new techniques for intracranial stent navigation were usefully implemented.
