Application of a TREVO device for access to an acutely angled common carotid artery via bovine aortic arch

Title : Application of a TREVO device for access to an acutely angled common carotid artery via bovine aortic arch

Abstract:

Background: Access to the common carotid artery is crucial for any neuro-interventional procedures.  Bovine aortic arch followed by an acutely angled proximal common carotid artery (CCA) can pose a great challenge.  Owing to urgency, we resorted to a non-conventional method to obtain an access to the CCA: TREVO device.

Case: A 69 year old female with left MCA M1 infarction was prepped for a mechanical thrombectomy.   In addition to severely tortuous femoral artery and bovine aortic arch, her proximal CCA was also acutely curved, which precluded the guiding catheter advancing to the CCA.  Following several attempts with different catheters and wires, a TREVO device was introduced and deployed in the proximal internal carotid artery (ICA), which ultimately allowed a sofia intermediate catheter to reach the distal ICA.  Through this rather unconventional method, M1 infarction was successfully treated.

Conclusion: When having to pass through unfortunate routes in the aortic arch and CCA, a trevo device might help advancing the guiding catheter to the ICA, which is an absolute necessity in successful neuro-intervention.

Biography:

Dr. Jae-Sung Park is currently a tenured professor in the Department of Neurosurgery at Konyang university, Daejeon, South Korea. Dr. Park received his MD and master degree from Chung-Ang University, Seoul, Korea, where he completed his Neurosurgery residency. He earned his PhD from Sungkyunkwan University,Seoul, Korea in 2019. In 2007 he was employed by the Cleveland Clinic Foundation for Skull Base Surgery fellowship with Dr. Joung H. Lee, in Cleveland, OH, US. An additional fellowship was also completed in the Center for Neurological Restoration (Cleveland Clinic Foundation) with Dr. Ali Rezai. Since he had returned back to Korea in 2010, he made a clinical professor in 2012 and a tenured professor in 2023. In 2019, he expanded his expertise to endovascular intervention surgeries by completing a fellowship program at Severance hospital, Seoul, Korea. He has more than 20 publications to date.