Transcarotid retrograde stenting for common carotid artery ostial stenosis: how I do it

We present a surgical technique for retrograde stenting of ostial stenosis of the common carotid artery (CCA) in a 74-year-old male patient. The carotid bifurcation was widely exposed. A 9-French (Fr) balloon guide catheter (BGC) was inserted via a small arteriotomy of the CCA and fixed using balloon inflation. The BGC was curved and placed toward the leg side. Transluminal angioplasty followed by stent deployment was then performed. The contrast medium injected via a diagnostic 4-Fr catheter was aspirated through the BGC. Our modified transcarotid retrograde stenting technique appears to be a feasible approach for managing ostial stenosis of the CCA.