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Abstract - Technical Note

J Cerebrovasc Endovasc Neurosurg. 2020 22(1): 26-30
The Journal of Cerebrovascular and Endovascular Neurosurgery
Spasm, stenosis and shelves: balloon-assisted tracking techniques in endovascular interventions
Melanie Walker1, Louis J Kim1, Michael R Levitt1, Basavaraj Ghodke2
1 Department of Neurological Surgery and Stroke and Applied Neurosciences Center, University of Washington School of Medicine, Seattle, WA, USA, 2Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA

The technique of balloon-assisted tracking (BAT) has been demonstrated in transradial cardio-angiographic procedures. Using three commonly encountered clinical scenarios, we outline the technical details of BAT for managing peripheral and cerebral interventions with challenging vascular access. We describe methods used to overcome vasospasm, stenosis and vascular shelves during interventions for acute ischemic stroke, but these issues are not unique to neuroendovascular cases and the techniques can be applied across all endovascular interventions. We present three acute stroke interventions where anatomic challenges were overcome with the use of endovascular BAT. This article describes a novel application for BAT techniques in endovascular interventions to assist with access in peripheral, cervical and intracranial vessels. These methods can also be used to improve access during diagnostic cerebral angiography. BAT is a useful adjunct when navigating catheters through vasospasm, tortuous anatomy, vascular step-offs or intraluminal plaques.
Key words : Balloon, Tracking, Stroke, Endovascular

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