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AJNR - American Journal of Neuroradiology

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Carotid-compression Technique for the Insertion of Guiding Catheters

S. Yoshimura^a, Y. Enomoto^a, H. Kitajima^a, J. Yamada^a, Y. Kaku^b and T. Iwama^a

^a Department of Neurosurgery, Graduate School of Medicine, Division of Neuroscience, Gifu University
Asahi, Japan
^b Department of Neurosurgery, Murakami Memorial Hospital, Asahi University, Asahi, Japan

View larger version (117K): [in a new window]   Fig 1. Carotid-compression technique I. A, After insertion of the guidewire, the CCA is manually compressed (arrow). B, The inner catheter (Glidecath, Terumo, Tokyo, Japan) is first inserted along the guidewire stabilized by manual compression of the CCA. The guiding catheter (Guider, Boston-Scientific, Natick, Mass) is then inserted along the inner catheter. Arrowheads indicate the tip of the guiding catheter.

View larger version (109K): [in a new window]   Fig 2. Carotid-compression technique II. A, The coaxial system (Shuttle, Cook/Glidecath, Terumo, Bloomington, Ind) is inserted into the ascending aorta, and the guidewire and inner catheter are then introduced into the target CCA or ICA by using the turn-over technique. B, The CCA is then compressed manually (arrow) to stabilize the guidewire and inner catheter. C, Withdrawal of the system toward the femoral artery results in its straightening. D, The guiding catheter is then advanced along the inner catheter. Arrowheads indicate the tip of the guiding catheter.