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      Stenting of Variant Left Carotid Artery Using Brachial Artery Approach in a Patient with Unusual Type of Bovine Aortic Arch

      case-report

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          Abstract

          Bovine aortic arch is the most frequently encountered variation in human aortic arch branching. A 63-year-old Asian male presented with symptomatic severe stenosis of left carotid artery originating from the brachiocephalic trunk. Selective engagement to the left carotid artery was unsuccessful using transfemoral approach. We reported on a successful left carotid artery stenting case using right brachial artery approach in a bovine aortic arch. This paper is worthy of reporting in terms of guiding physicians for interventional procedures in these types of challenging cases.

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          Bovine aortic arch variant in humans: clarification of a common misnomer.

          E. Paul Lindell, D Kallmes, Antony V. Cox … (2006)
          The term "bovine arch" is widely used to describe a common anatomic variant of the human aortic arch branching. This so-called bovine aortic arch has no resemblance to the bovine aortic arch. We describe the most common human aortic arch branching patterns and compare these with the bovine aortic arch.
          Article 0 comments Cited 28 times – based on 0 reviews     Review now
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            Current global status of carotid artery stent placement.

            H Londero, F Shawl, Juan Borreguero-León … (1998)
            Our purpose was to review the current status of carotid artery stent placement throughout the world. Surveys were sent to major interventional centers in Europe, North and South America, and Asia. Information from peer-reviewed journals was also included and supplemented the survey. The survey asked various questions regarding the patients enrolled, procedure techniques, and results of carotid stenting, including complications and restenosis. Of the centers which were sent surveys, 24 responded. The total number of endovascular carotid stent procedures that have been performed worldwide to date included 2,048 cases, with a technical success of 98.6%. Complications that occurred during carotid stent placement or within a 30-day period following placement were recorded. Overall, there were 63 minor strokes, with a rate of occurrence of 3.08%. The total number of major strokes was 27, for a rate of 1.32%. There were 28 deaths within a 30-day postprocedure period, resulting in a mortality rate of 1.37%. Restenosis rates of carotid stenting have been 4.80% at 6 mo. Endovascular stent treatment of carotid artery atherosclerotic disease is growing as an alternative to vascular surgery, especially for patients that are at high risk for standard carotid endarterectomy. The periprocedural risks for major and minor strokes and death are generally acceptable at this early stage of development.
            Article 0 comments Cited 16 times – based on 0 reviews     Review now
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              Feasibility and safety of transbrachial approach for patients with severe carotid artery stenosis undergoing stenting.

              Chiung-Jen Wu, Cheng-I Cheng, Wei-Chin Hung … (2006)
              Although sporadic successful cases using the transradial approach (TRA) for carotid stenting have been reported, the safety and feasibility of carotid stenting using either TRA or a transbrachial approach (TBA) have not been fully investigated. Recently, we have developed a safe and feasible method of TRA for cerebrovascular angiographic studies. This study investigated whether a TBA approach using a 7-French (F) Kimny guiding catheter for carotid stenting is safe and feasible for patients with severe carotid stenosis. Thirteen patients were enrolled into this study (age range, 63-78 years). Seven of these 13 patients had severe peripheral vascular disease. A retrograde-engagement technique, involving looping 6-F Kimny guiding catheter, was utilized for carotid angiographic study. For carotid stenting, the 6-F Kimny guiding catheter was replaced with a 7-F Kimny guiding catheter, and the procedure was performed as the follows. First, an extra-support wire was inserted into the middle portion of external carotid artery (ECA). Second, a 0.035-inch Teflon wire was advanced into the common carotid artery. Then, the 6-F guiding catheter was exchanged for a 7-F Kimny guiding catheter. Third, if the first and second steps did not provide adequate support for exchanging the guiding catheter, a PercuSurge GuardWire was inserted into the ECA, followed by distal balloon inflation for an anchoring support. FilterWire EX was used in 9 patients and PercuSurge GuardWire in 4 patients to protect from distal embolization during the procedure. The procedure was successful in all patients. No neurological or vascular bleeding complications were observed and all patients were discharged uneventfully. The TBA for carotid stenting was safe and effective, providing a last resort for patients unsuited to femoral arterial access and surgical intervention.
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Cardiol
                Journal ID (iso-abbrev): Case Rep Cardiol
                Journal ID (publisher-id): CRIC
                Title: Case Reports in Cardiology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6404
                ISSN (Electronic): 2090-6412
                Publication date (Print): 2016
                Publication date (Electronic): 28 January 2016
                Volume: 2016
                Electronic Location Identifier: 9512318
                Affiliations
                1Department of Cardiology, Ordu State Hospital, 52200 Ordu, Turkey
                2Department of Cardiology, Ordu University Hospital, 52200 Ordu, Turkey
                3Department of Cardiology, Giresun University Hospital, 28200 Giresun, Turkey
                4Department of Cardiovascular Surgery, Giresun University Hospital, 28200 Giresun, Turkey
                Author notes

                Academic Editor: Kuan-Rau Chiou

                Article
                DOI: 10.1155/2016/9512318
                PMC ID: 4749776
                PubMed ID: 26942020
                SO-VID: 0e22ca46-0cef-45b3-8653-efe4095747b3
                Copyright © Copyright © 2016 Emre Gürel et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 November 2015
                Date accepted : 3 January 2016
                Categories
                Subject: Case Report

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