ABSTRACT
Vascular access was obtained in the right common femoral artery with a 8 Fr sheath and 10 000 IU heparin were given. An additional 4000 IU heparin were given to maintain an activated clotting time (ACT) of over 300 s during the procedure. A diagnostic 6 Fr JR-4 catheter was used to cannulate the left subclavian artery and left vertebral artery ostium selectively. A 0.035-inch Wholey (Malinckrodt, St Louis, MO, USA) guidewire was then advanced into the V2 segment of the artery and the diagnostic catheter was exchanged for a 8 Fr JR-4 coronary guiding catheter. A 4 mm × 2 cm Opti-5 (Cordis, Miami, FL) angioplasty balloon was used to perform predilatation. A Palmaz P104 (Cordis) stent was mounted on a 5 mm × 2 cm Opti-5 balloon (Cordis) and deployed at the ostium of the left vertebral artery (Figure 6.3). Note that the short stent allowed the tortuous segment of this artery to remain unchanged.
