• Kiyoshi Tsuji, Norihito Fukawa, Nobuhiro Nakagawa, Akira Watanabe, Saori Murakami, Kazuhiro Nagatsuka, Naoki Nakano, Kazuo Kataoka, and Amami Kato.
• *Department of Neurosurgery, Kinki University School of Medicine, Osaka, Japan; ‡Department of Neurosurgery, Nara Hospital, Kinki University School of Medicine, Nara, Japan.
• Neurosurgery. 2016 Oct 1; 79 (4): 598-603.

BackgroundTransfemoral stenting of stenoses at the common carotid artery (CCA) origin is technically difficult because of poor stability of the guiding catheter.ObjectiveTo describe an anchoring technique using a balloon protection device that provides excellent stability of the guiding catheter.MethodsFour patients (5 stenotic lesions) with stenosis of the CCA origin underwent transfemoral stenting with a balloon protection device (PercuSurge GuardWire; Medtronic, Santa Rosa, California). These 5 stenotic lesions of the CCA origin included 1 on the right side and 4 on the left side. Two of the stenoses were symptomatic, and 3 were asymptomatic. A balloon-expandable stent (Express LD stent; Boston Scientific, Natick, Massachusetts) was used in all patients.ResultsAll stenoses were successfully dilated. With the balloon protection device as an anchor in all patients, the guiding catheter was highly stable during the procedure. There were no intraprocedural or periprocedural ischemic complications in any patients. None of the patients developed a stroke during a mean follow-up period of 8.4 months.ConclusionThe anchoring technique using a balloon protection device is useful for transfemoral stenting of stenoses at the CCA origin.AbbreviationsCCA, common carotid arteryECA, external carotid arteryICA, internal carotid arteryPTA, percutaneous transluminal angioplasty.

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