Second Coming of Snare-Assisted Stabilization Technique in Cases of Difficult Catheter Access.

Objective: The snare-assisted stabilization technique can address difficult catheter access in cases such as type III aortic arch. This technique can provide additional support to the treatment system, and it has received attention again in the current era of distal access catheter. Because there are a limited number of reports on this technique, the current study showed the details of this technique and also evaluated the usefulness and safety of the snare-assisted stabilization technique.

Case presentation: This is a retrospective observational study at a single center. The consequent cases using the snare-assisted stabilization technique from November 2016 to December 2024 were retrospectively reviewed. The main endpoints were morbidity, mortality rate at discharge, and the success ratio of treatments using this technique. This study included 20 patients. The patients' median age was 73 years, and 70% (n = 14) were men. The primary causes of difficult catheter access included torturous or narrow vertebral artery (n = 13, 65%), type III aortic arch (n = 5, 25%), and short-segment common carotid artery proximal to the lesion (n = 2, 10%). The snare-assisted stabilization technique consistently facilitated improved support, resulting in successful procedures in all cases. In 95% (n = 19) of the cases, the procedures were completed without complications.

Conclusion: The snare-assisted stabilization technique is effective and safe for improving the guiding system support and addressing catheter access challenges. This technique should come back into the spotlight in the era of distal access catheters.