The use of curved sheath technique to facilitate difficult internal carotid artery occlusions

Abstract

Carotid Artery Occlusive Disease or Carotid Artery Stenosis (CAS), a widely prevalent disease, involves blockage of the arterial wall through atherosclerotic plaques. Due to the high prevalence of carotid artery stenosis, innovative approaches to improve the outcome are required, particularly for more difficult and unique cases. Within this report, we present a particularly difficult case of Type III Aortic Arch – Right Internal Carotid Artery (ICA) stenosis making it a challenging case. We describe a symptomatic 87-year-old male who presented to Cardiology clinic. CT angiogram showed 70% occlusion of right internal carotid artery and patient was deemed high risk for carotid artery surgery; hence, the patient underwent internal carotid artery stenting. After the procedure, angiogram results were excellent, and the patient was transferred to CICU in stable hemodynamic condition. This case demonstrates the significance of innovative new techniques in the development of medical treatment.
 Keywords: Carotid Artery Stenting, Curve Sheath Technique, Type 3 Aortic Arch, Right Internal Carotid Artery Stenosis