Slides Endovascular Peripheral Disease Subclavian
Complex Stenting (T-Stenting) of Left Subclavian Artery & Vertebral Artery Stenosis
- Operator : Seung-Whan Lee
Complex Stenting (T-Stenting) of Left Subclavian Artery & Vertebral Artery Stenosis |
- Operator: Seung-Whan Lee. MD |
Clinical Information |
- Relevant clinical history and physical
exam: - Relevant test results prior to catheterization: - Relevant angiography findings: |
Interventional Management |
- Procedural step: After Rt. femoral puncture, 7Fr sheath was inserted. The 5 Fr head-hunter catheter using 0.032 inch Terumo wire was engaged into left subclavian artery. And then was exchanged to 7Fr Shuttle. The 0.014 inch coronary floppy guide wire was inserted into left VA artery. The VA ostial stenotic lesion was predilated with coronary Quantum balloon (3.0 x 12 mm) upto nominal pressure. (Figure 4) We deployed the Genesis stent 5.0 x 15 mm. (Figure 5) At stepwise intervention, We deployed Genesis stent 9.0 x 39 mm at Lt.subclavian stenotic lesion, resulting T-stenting bifurcation technique with previous stent. (Figure 6, Figure 7, Figure 8) The post-stent balloon dilatation with Powerflex 9.0 x 20 mm was done at Lt. subclavian artery stenting lesion. The 0.014 inch coronary guide-wire was re-inserted into VA and the high pressure ballooning with non-compliant balloon was done. (Figure 9) The final angiogram showed successful stenting at Lt.subclavian artery and Lt.VA ostial lesion without any procedural related neurologic complications. (Figure 10, Figure 11) |
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