Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Yoshiki Hanaoka ◽  
Daisuke Yamazaki ◽  
Jun-ichi Koyama ◽  
Tetsuyoshi Horiuchi
Keyword(s):  
Vertebral Artery ◽  
Transfemoral Approach ◽  
Subclavian Stenosis

Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Aldo A Mendez ◽  
Alan Mendez-Ruiz ◽  
Rami Fakih ◽  
Mudassir Farooqui ◽  
Sudeepta Dandapat ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Subclavian Artery ◽  
Rare Complication ◽  
Balloon Catheter ◽  
Left Vertebral Artery ◽  
Complication Rates ◽  
Distal Embolization ◽  
Transfemoral Approach ◽  
Patient Consent ◽  
Subclavian Stenosis

Abstract Endovascular intervention has become the mainstay of treatment for subclavian artery stenosis in many centers, with high technical success and low complication rates.1,2 However, potential embolization during proximal subclavian artery intervention can lead to catastrophic posterior circulation ischemic complications.3-5 Although considered a rare complication, the presence of a contralateral hypoplastic vertebral artery with persisting anterograde vertebral blood flow on the affected side is likely to increase the risk of embolization.3 The use of embolic protection devices, such as filters and noncompliant balloons, has been previously described.3,6,7 However, there is still a risk of distal embolization and vessel injury with the use of these devices.7 We present a technical video of a patient in their 80s with left subclavian stenosis who underwent subclavian stent-assisted percutaneous transluminal angioplasty (SAPTA) using an anterograde-retrograde access technique with a dual-lumen compliant balloon catheter (Scepter XC; MicroVention, Aliso Viejo, California) placed at the proximal segment of the left vertebral artery. With this approach, the compliant balloon provides adequate protection while minimizing the risk of endothelial injury and distal embolization.  Written informed consent was obtained for the procedure. Patient consent was waived because all health information was deidentified.

scholarly journals Basilar Artery Blood Flow in Subclavian Steal

1988 ◽  
Vol 15 (4) ◽  
pp. 417-419 ◽  
Author(s):  
Natan M. Bornstein ◽  
Adam Krajewski ◽  
John W. Norris
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Basilar Artery ◽  
Transcranial Doppler ◽  
The Other ◽  
Artery Blood Flow ◽  
Subclavian Steal ◽  
Doppler Techniques ◽  
Subclavian Stenosis ◽  
Age And Sex

ABSTRACT:Subclavian “steal”, when blood siphons from one vertebral artery to the other, has been suggested as a cause of brain stem ischaemia and stroke. We investigated 33 patients using transcranial Doppler to determine the direction and velocity of basilar blood flow. All patients had severe subclavian stenosis with reversed vertebral blood flow in the ipsilateral artery previously demonstrated by extracranial Doppler. Basilar flow was normal in direction in all cases, but its velocity was significantly increased (p<0.0008) compared to age- and sex-matched controls. These findings, in conjunction with previous observations using extracranial Doppler techniques, suggest that subclavian steal is little more than a harmless haemodynamic phenomenon.

Isolated reversal of flow in the vertebral artery – A missed entity

2021 ◽  
pp. 021849232110063
Author(s):  
Koushik Kannan ◽  
Ramanish Ravishankar ◽  
Srinivasan Muralidharan
Keyword(s):  
Vertebral Artery ◽  
Posterior Circulation ◽  
Bypass Grafting ◽  
Common Cause ◽  
Arterial Bypass ◽  
Off Pump ◽  
Neurological Outcomes ◽  
Steal Syndrome ◽  
Subclavian Stenosis ◽  
Anatomical Defects

Isolated reversal of flow in the vertebral artery is a rare phenomenon occurring in the general population and is due to intrinsic anatomical defects. The most common cause is subclavian stenosis; however, reversal of flow in the vertebral artery can occur regardless of any detection of anatomic deterioration. In this series, we report three asymptomatic cases where the extracranial Doppler scan preceding off-pump coronary arterial bypass grafting showed isolated reversal of flow in the vertebral artery. No signs of subclavian stenosis or steal syndrome were elicited. However, all patients subsequently suffered from a posterior circulation stroke following off-pump coronary arterial bypass grafting but recovered fully with medical management. We conclude that a detailed pre-operative neurological investigation can mitigate this risk and improve neurological outcomes following off-pump coronary arterial bypass grafting.

Relationships between vertebral artery diameter and dissecting aneurysm formation

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S148-S148
Author(s):  
Yoko Yokoyama ◽  
Shigeru Fujimoto ◽  
Kazunori Toyoda ◽  
Tooru Inoue ◽  
Juro Jinnouchi ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Dissecting Aneurysm ◽  
Aneurysm Formation

Preferential involvement of hypoplastic vessels in vertebral artery dissection: a comparative study

2011 ◽  
Vol 42 (01) ◽  
Author(s):  
R.J. Strege ◽  
P. Hohnstädt ◽  
H. Schindler ◽  
T. Vestring ◽  
R. Kiefer
Keyword(s):  
Comparative Study ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection

A Case of Vestibular Paroxysmia Offended by Vertebral Artery

2012 ◽  
Vol 55 (6) ◽  
pp. 386 ◽  
Author(s):  
Byung-Jae Yu ◽  
Se-Hwan Hwang ◽  
Dong-Joon Yoo ◽  
Jae-Hyun Seo
Keyword(s):  
Vertebral Artery ◽  
Vestibular Paroxysmia

Radiological Findings of Vertebral Artery Dissection

1995 ◽  
Vol 33 (4) ◽  
pp. 507
Author(s):  
Ik Won Kang ◽  
Kil Woo Lee ◽  
Ji Hun Kim ◽  
Hong Kil Suh ◽  
Kyu Sun Kim ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Radiological Findings
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