Carotid Artery Stenting using MOMA Ultra Cerebral distal protection device in Left Internal Carotid Artery Stenosis

- Operator : Seung-Whan Lee

Carotid Artery Stenting using MOMA Ultra Cerebral distal protection device in Left Internal Carotid Artery Stenosis
- Operator: Seung-Whan Lee, MD
Case Presentation
A 74 year-old gentleman was admitted with the severe stenosis of left carotid artery. A MR angiogram showed a significant stenosis of Lt. carotid bulb and internal carotid artery. He had a history of hypertension and hyperlipidemia.
Baseline carotid angiography
A carotid angiogram showed significant stenosis in the Lt. ICA (Figure 1).
Procedure
An 9 Fr sheath was inserted into right femoral artery. Left carotid artery was engaged with Rt. JR4 diagnostic catheter through 0.032 inch terumo wire 260cm, and then carotid and cerebral angiograms were taken (Figure 1). Firstly, we positioned MOMA Ultra Cerebral distal protection device 9 Fr at Lt. carotid artery, and inflated distal balloon of protection device (Figure 2). And then, we inserted 0.014 inch Sion blue wire - 180cm into Lt. ICA, and inflated proximal balloon of protection device (Figure 3). We predilated Lt. ICA lesion with a Fortis 3.5 x 18cm balloon (Figure 4). After predilatation, we performed debriment suction between MOMA catheter balloons using 20cc synringe. We deployed COMPLETE SE stent 7.0-10 x 40cm (Cristallo self expandable) from ICA to CCA, Lt (Figure 5). Finally, we performed adjunctive post-dilatation using Pacific 5.0 x 20 cm balloon, and removed debriments by suction inside protection device. All procedure was uneventful. Final carotid angiogram showed good result with no residual diameter stenosis (Figure 6).

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