Induction of a Guiding Sheath to Carotid Artery without Intra-aortic Manipulation by Using a Pigtail-type Inner Catheter: Technical Note and Report of Two Cases

Objective: Catheter operations in the aortic arch with atheromatous ulcers, aortic aneurysms, or artificial blood vessels increase the risk of complications, such as cholesterin embolism. We report two cases in which a guiding sheath was directly guided into the right carotid artery through the radial artery using a 5 Fr 110-cm pigtail catheter as an inner catheter to avoid the above complications.Case Presentations: Case 1: A 51-year-old female with an anterior communicating artery aneurysm. Balloon-assisted embolization of the aneurysm was performed using this method as she had undergone aortic arch replacement.Case 2: A 74-year-old male with stenosis of the right internal carotid artery. Carotid artery stenting (CAS) was conducted using this method due to shaggy aorta.Conclusion: This method may be simple and useful for avoiding the complexity of catheter exchange and risk of intra-aortic-arch manipulation.