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Abstract Details

Flow-Diverting Stent Placement in a Pediatric Patient Through Radial Artery Approach
Cerebrovascular Disease and Interventional Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
4-019
While trans-radial access (TRA) has been well described in cardiac intervention it is now in its’ beginnings in the realm of cerebrovascular interventions. TRA for cardiac intervention has been seldom described in the pediatric population and to our knowledge has never been described in the pediatric population for cerebrovascular intervention. Here we discuss our experience with placement of a flow diverting stent using TRA in a pediatric patient.
A 15-year-old female was struck by a motor vehicle. CTA revealed dissection of the right internal carotid artery (ICA). Initial Diagnostic angiogram showed a nonflow limiting dissection involving mid to distal cervical segment of Right ICA, without evidence of any pseudoaneurysm. Follow-up MRA showed stenosis of the right ICA, with a new pseudoaneurysm measuring 8mm x 5mm x 6mm with a 4mm neck. Flow- diverting stent placement was chosen for treatment and TRA was considered to minimize radiation to the patient.
n/a
Right radial artery diameter was measured 2.1mm with ultrasound. Right radial artery was punctured with 2 cm 21 g needle, under ultrasound guidance. A 6 french sheath was placed in radial artery and spasmolytics were injected. A guide catheter was advanced into the distal Right common carotid artery with the help of a Sim 2 select catheter. Angiography showed around 50% narrowing of mid to distal cervical ICA with a pseudoaneurysm in the middle of the stenosed segment projecting laterally and superiorly. A microwire was navigated into the petrous portion of the internal carotid artery and a microcatheter was advanced over the microwire. An intermediate catheter was advanced into the proximal cervical segment of the Right ICA. The pipeline embolization device was deployed under real-time fluoroscopy.
TRA may be safer with decreased possibility for complication when compared to femoral access and should be considered more often in pediatric patients.
Authors/Disclosures
Ivo Bach, MD
PRESENTER 		Dr. Bach has nothing to disclose.
Pratit D. Patel, MD (Capital Health) Dr. Patel has nothing to disclose.
No disclosure on file
Priyank Khandelwal, MD Dr. Khandelwal has nothing to disclose.