PT  - JOURNAL ARTICLE
AU  - Elisa Colombo
AU  - Lorenzo Rinaldo
AU  - Giuseppe Lanzino
TI  - Direct carotid puncture in acute ischaemic stroke intervention
AID  - 10.1136/svn-2019-000260
DP  - 2020 Jan 29
TA  - Stroke and Vascular Neurology
PG  - svn-2019-000260
4099  - http://svn.bmj.com/content/early/2020/01/29/svn-2019-000260.short
4100  - http://svn.bmj.com/content/early/2020/01/29/svn-2019-000260.full
AB  - Endovascular intervention for acute ischaemic stroke care is mostly performed in older patients, often with unfavourable aortic and supra-aortic anatomy, as well as cardiovascular comorbidities. A significant subset of them may benefit from transcervical access as the initial approach for mechanical thrombectomy. In fact, direct carotid artery puncture in these cases has the advantage to bypass the anatomical obstacles and achieve faster reperfusion. Caution is advised when common carotid artery access is pursued in order to avoid adverse events, including haematoma formation, iatrogenic arterial dissection and sheath kinking. In spite of potential complications, direct carotid puncture in acute ischaemic stroke intervention overcomes challenging angioarchitecture and may reduce the rate of poor clinical outcomes associated with delayed revascularisation in certain cases.