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

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.