INDICATION FOR PROCEDURE:
Symptomatic carotid artery stenosis, for possible carotid stent.

ASSISTANT SURGEON:
Dr. B MD.

PROCEDURES PERFORMED:
Right common femoral artery access with a 5-French sheath, selective
right carotid angiogram, intracerebral angiogram.

COMPLICATIONS:
None.

ESTIMATED BLOOD LOSS:
Less than 2 mL.

DESCRIPTION OF PROCEDURE:
After informed consent, discussion of risks and benefits, a 5-French
sheath was placed in the right common femoral artery. The patient does
have an external iliac stenosis, which we got across with 0.18 wire,
which was then exchanged for a bigger micropuncture sheath, which was
exchanged for a stiff 0.35 wire, which was exchanged for a 5-French
sheath. The right carotid was selectively cannulated using the 3DRC
catheters. Selective angiography showed the common carotid to have
mild plaquing. There is ulceration of the common carotid and a maximum
of 30% to 40% of the internal carotid. The internal carotid although
has mild diffuse disease in the cavernous portion and goes on to give
the MCA and ACA. No significant obstruction. No aneurysm is seen.
The contralateral MCA can be seen filling through collaterals through
the anterior communicating, which also fills the MCA on the left. There
were
no complications. Recommend medical therapy. The sheath will be pulled
manually. Further recommendations to follow clinical course.