TY - JOUR
T1 - Crossing the Carotid Siphon
T2 - Techniques to Facilitate Distal Access in Tortuous Anatomy: 2-Dimensional Operative Video
AU - Endovascular Neurosurgery Research Group
AU - Hadley, Caroline
AU - Burkhardt, Jan Karl
AU - Johnson, Jeremiah N.
AU - Kan, Peter
AU - Arthur, Adam
AU - Bain, Mark
AU - Bendock, Bernard
AU - Binning, Mandy Jo
AU - Boulos, Alan S.
AU - Crowley, Webster
AU - Fessler, Richard
AU - Grande, Andrew
AU - Guterman, Lee
AU - Hanel, Ricardo
AU - Hoit, Daniel
AU - Hopkins, L. Nelson
AU - Howington, Jay
AU - James, Robert
AU - Jankowitz, Brian
AU - Kan, Peter
AU - Khalessi, Alex A.
AU - Kim, Louis
AU - Langer, David
AU - Lanzino, Giuseppe
AU - Levitt, Michael
AU - Levy, Elad
AU - Lopes, Demetrius
AU - Mack, William
AU - Mericle, Robert
AU - Mocco, J.
AU - Ogilvy, Chris
AU - Pandey, Aditya
AU - Replogle, Robert
AU - Riina, Howard
AU - Ringer, Andrew
AU - Rodriguez, Rafael
AU - Saugaveau, Eric
AU - Schirmer, Clemens
AU - Siddiqui, Adnan
AU - Spiotta, Alex
AU - Sultan, Ali
AU - Tawk, Rabih
AU - Thomas, Ajith
AU - Turner, Raymond
AU - Veznedaroglu, Erol
AU - Welch, Babu
AU - White, Jonathan
N1 - Publisher Copyright:
© Congress of Neurological Surgeons 2021. All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - As capabilities for endovascular treatment of intracranial vascular pathologies continue to expand, the need for access to the distal internal carotid artery with rigid support catheter systems continues to increase. One of the dominant factors limiting this access is patient anatomy, specifically vessel tortuosity. Increased tortuosity of the carotid siphon is a frequently encountered anatomic variant and may complicate endovascular procedures in adults and children.1,2 Failed attempts to navigate the carotid siphon with a distal access catheter carry a risk of vessel injury and treatment failure. For this reason, techniques that aid in supporting safe advancement of a distal access catheter across a tortuous carotid siphon are essential.3,4 In this video, we demonstrate 2 ways in which this may be accomplished. The first technique uses a larger diameter microcatheter, such as the AXS Offset catheter (Stryker, Kalamazoo, Michigan), to increase support for the distal access catheter, while the second uses a buddy wire technique to accomplish this increased support. Both of these techniques can help increase the safety of navigating a tortuous carotid siphon and increase the likelihood of successful treatment. The procedures shown were performed with the informed consent of the patients.
AB - As capabilities for endovascular treatment of intracranial vascular pathologies continue to expand, the need for access to the distal internal carotid artery with rigid support catheter systems continues to increase. One of the dominant factors limiting this access is patient anatomy, specifically vessel tortuosity. Increased tortuosity of the carotid siphon is a frequently encountered anatomic variant and may complicate endovascular procedures in adults and children.1,2 Failed attempts to navigate the carotid siphon with a distal access catheter carry a risk of vessel injury and treatment failure. For this reason, techniques that aid in supporting safe advancement of a distal access catheter across a tortuous carotid siphon are essential.3,4 In this video, we demonstrate 2 ways in which this may be accomplished. The first technique uses a larger diameter microcatheter, such as the AXS Offset catheter (Stryker, Kalamazoo, Michigan), to increase support for the distal access catheter, while the second uses a buddy wire technique to accomplish this increased support. Both of these techniques can help increase the safety of navigating a tortuous carotid siphon and increase the likelihood of successful treatment. The procedures shown were performed with the informed consent of the patients.
KW - Carotid siphon
KW - Endovascular techniques
KW - Intracranial stenting
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U2 - 10.1093/ons/opab084
DO - 10.1093/ons/opab084
M3 - Article
C2 - 33822191
AN - SCOPUS:85108303196
SN - 2332-4252
VL - 21
SP - E41-E42
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 1
ER -