Angioplasty with the stenting of the innominate artery with the protection of the common carotid artery

Abstract

We present the clinical observation of a patient undergoing treatment in the neurosurgical department of the Zaporizhzhya Regional Hospital. The patient complained of headache, dizziness, unsteadiness, occasional numbness and weakness of the right arm. The above complaints are aggravated by physical work and active use of the right hand. A CT-AH (Toshiba Asteion 64 slices) revealed a functioning left subclavian artery stent, a high-grade innominate artery stenosis and a small stenosis of the common carotid artery orifice on the left. Stenting of the innominate artery with transition to the common carotid artery with the use of system for distal neuroprotection was performed. The result of stenting is optimal. The patient notes a regression of the manifestations of the vestibulo-atactic syndrome, as well as signs of the coming ischemia of the upper limb. At the control examination a month after the operation there is a regression of cerebral symptomatology, cephalgic syndrome. The stenting of the innominate artery with a femoral access is effective. The use of system for distal neuroprotection increases the safety of the intervention. The use of an additional guiding microguidewire allows the safe conduct of system for distal neuroprotection through the bends of the vascular bed with acute angles.