Proximal Balloon Protection during Carotid Artery Stenting via the Transradial Approach

Objective: We report two patients for whom the proximal balloon protection (PBP) method was used during transradial carotid artery stenting (TR-CAS).Case Presentations: Case 1 was a 79-year-old male. TR-CAS for acute occlusion of the internal carotid artery was performed. A 6 Fr balloon guiding catheter was introduced into a 6 Fr guiding sheath, and CAS was conducted by passing through the lesion under PBP. Case 2 was an 83-year-old male. TR-CAS was performed to treat marked stenosis of the internal carotid artery. It was difficult to pass the catheter through the lesion, but PBP with a balloon guiding catheter enhanced the supporting power, facilitating lesion passage, and CAS was successful.Conclusion: No study has reported PBP during TR-CAS, but we were able to perform PBP during TR-CAS by adopting this method, and the support for lesion passage may be enhanced. This method may be useful for patients at risk of distal embolism or for those in whom lesion passage is difficult.