Purpose : This study was to investigate the usefulness of a combination of a support catheter and a custom-made polyurethane material with a reverse curve catheter and a roadrunner guide wire for patients who had difficulty accessing the common carotid artery stenting.
Object and Method : 24 patients who underwent carotid stenting from October, 2016 to March, 2017 were enrolled in this study. Procedural method, cervical arch type, presence of aortic arch in MRA or CTA, catheter type were used to compare Fluoro time and total DAP in all 24 patients.
Result : The mean Fluoro time and Total DAP of conventional method group was 18.5min and 1358.3mGy, respectively. And mean value of Fluoro time and Total DAP of new method group was 26.1min and 2108.2mGy. The group with presence of aortic arch in MRA or CTA, the mean Fluoro time and Total DAP was 19.8min and 1458.1mGy. For the group without cervical arch in the MRA or CTA, 24.9min and 2058.8mGy, respectively. Further more, in the group with presence of aortic arch in MRA or CTA, Fluoro time for type A was 16.2min, for Type B was 24.6min, for Type C was 23.4min. The Total DAP for type A was 1143.4mGy, for Type B was 1786.7mGy, for Type C was 1959.7mGy.
The mean Fluoro time and Total DAP when we using only H1 catheter was 18.5min and 1358.3mGy. And that was 19.0min and 1680.5mGy for SIM3 catheter alone. When we were using the H1 and SIM3 catheter together, the mean Fluoro time and Total DAP was 28.5min and 2250.8mGy.
Conclusion : This study showed that the combination of a support catheter and a custom-made polyurethane material with a reverse curve catheter(SIM3; 135cm) and a roadrunner guide wire shorten the fluoro time and reduced the total DAP for type C of cervical arch patients. This method would be a considerable option for patients who had difficulty accessing the common carotid artery stenting.
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