Objectives: Carotid artery stenting (CAS) by proximal occlusion of the common carotid artery (CCA) using a balloon guide catheter (BGC) is a simple proximal protection method to prevent distal embolism, however, it requires at least an 8 French (F) system. A 7 F Optimo BGC is the smallest BGC with an inner lumen diameter of 0.071 inches, and which permits the passage of a 5 F carotid stent. We retrospectively investigated the clinical results and the safety of CAS by using a 7 F Optimo BGC combined with a distal filter.
Materials and methods: One-hundred carotid arterial stenosis patients were treated with CAS using combined protection of a 7 F Optimo BGC and a distal filter. The BGC was navigated from the femoral and radial arteries in 85 and 15 patients, respectively.
Results: The 7 F Optimo BGC was successfully navigated into the CCA in all patients, and the technical success rate of CAS was 100%. Major adverse events of any death, stroke, or myocardial infarction within 30-day after the procedure were observed in one (1%). Post-procedural diffusion-weighted magnetic resonance imaging revealed high signals in 21% of the patients, all of whom were asymptomatic.
Conclusions: The 7 F Optimo is the smallest BGC to achieve CAS using a proximal protection system. The combined use of a 7 F Optimo BGC and a distal filter is effective for navigating the BGC and distal embolic protection.
Keywords: Carotid artery stenting; balloon guide catheter; distal filter protection; proximal protection.