Novel Flow Reversal Technique Using Dual-Balloon Inflation for Right Common Carotid Artery Stenosis: A Technical Case Report.

Abstract

Objective: Herein, we present a novel flow reversal technique using dual-balloon inflation that can provide enhanced catheter stability and reliable embolic protection for percutaneous antegrade stenting in a patient with right common carotid artery (CCA) stenosis.

Case presentation: A 75-year-old female patient with post-radiation right CCA stenosis initially underwent stenting using distal filter protection, which resulted in transient left upper limb paralysis caused by embolic infarction. After restenosis at 6 months, retreatment was performed using dual-balloon occlusion with the 9-F balloon guiding catheter in the innominate artery and the 8-F balloon guiding catheter in the right subclavian artery. Intraoperative ultrasonography confirmed a successful flow reversal, and debris was captured from the aspirated blood. The patient was discharged without neurological deficits, and postoperative imaging showed no new ischemic lesions.

Conclusion: The novel flow reversal technique using dual-balloon inflation can be effective and safe for treating right CCA stenosis by achieving both reliable embolic protection and improved catheter stability.