Video : COMPLEX POST RADIOTHERAPY RIGHT INTERNAL CAROTID ARTERY STENOSIS

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Endovascular / Carotid / Case in the box

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Case presentation

Clinical Data

Man, 82 years,
HTN, past smoking
Cancer of the tongue treated with radiotherapy
Occlusion of the Left internal carotid artery
Severe stenosis of the right internal carotid artery
Unsuccessfull surgical attempt to revascularize the right internal carotid artery

Previous Imaging

Angio:

Severe, long, irregular and sinuous stenosis of the right internal carotid artery, 1,5 cm above the bifurcation
Occlusion of the Left Internal Carotid artery
Poor suppleance from the right carotid to the left territories which depends almost exclusively on left vertebral vascularization

Steps of the procedure:

1. access:

Right femoral access, 8F, 23 cm BRITE TIP ® sheath, Cordis
Selective Catheterism of the Right Common Carotid Artery with a H-Stick 8F, 100 cm Guiding Catheter (Cordis),

2. Distal embolic protection device placement

Deploiement of an Emboshield Pro Filter Carotid Protection ( Abbott Vascular)

3. Predilation, stenting and postdilation:

Predilation with a 4 x 30 mm TREK Coronary Balloon, Abbott
Deploiement of a 7-9 x 60 mm X-ACT Closed Cells Stent ( Abbott Vascular)
Postdilation with a 6 x 20 mm balloon

4. Retrieval af the filter

Shooting date : 2012-07-25
Last update : 2021-06-09