case_images: PMC11021079_01
case_images: Non-slip element percutaneous transluminal angioplasty (NSE PTA) balloon. (a) The NSE PTA balloon is a non-slip angioplasty catheter with three nylon scoring elements for controlled scoring of the vessel wall and reducing slippage during balloon inflation. (b) Stabilization of the balloon within the lesion during inflation. (c) Provision of an effective scoring effect through high concentrated force transmission (arrow).
case_images: SNI-15-91-g001.jpg
case_images: PMC11021079_01_SNI-15-91-g001.jpg
case_images: F1
case_images: An NSE PTA balloon with three longitudinal nylon elements attached proximally and distally to the balloon component was used as a pre-dilatation step [Figure 1a].
case_images: (a and b) Initial magnetic resonance imaging, diffusion-weighted image, (c and d) fluid-attenuated inversion recovery image, and (e and f) magnetic resonance angiography showing acute and subacute infarcts in the territory of the right internal carotid artery (ICA) and right cervical ICA stenosis.
case_images: SNI-15-91-g002.jpg
case_images: PMC11021079_01_SNI-15-91-g002.jpg
case_images: F2
case_images: At the initial presentation, cranial magnetic resonance imaging/cranial and cervical magnetic resonance angiography revealed right cervical internal carotid artery (ICA) stenosis; moreover, acute and subacute infarctions in the right ICA territory were observed on diffusion-weighted image sequences [Figure 2].
case_images: (a) Preoperative three-dimensional computed tomography angiography (CTA) and (b) sagittal CTA showing a right carotid artery with high-grade stenosis caused by a multifocal calcified plaque.
case_images: SNI-15-91-g003.jpg
case_images: PMC11021079_01_SNI-15-91-g003.jpg
case_images: F3
case_images: A head and neck computed tomography angiogram revealed a focal area of high-grade calcified stenosis [Figure 3].
case_images: Intraprocedural common carotid angiograms of the patient with severe calcified stenosis of the right carotid artery who underwent carotid artery stenting (CAS) with a non-slip element percutaneous transluminal angioplasty (NSE PTA) balloon. (a) A common carotid angiogram reveals severe stenosis (white arrow) of the right cervical internal carotid artery (ICA) (white arrow). (b) An NSE PTA balloon was placed in the cervical ICA, centered on the stenotic lesion, and used for pre-dilatation in the CAS. The NSE PTA balloon was inflated three times with Filter-Wire EZ underprotection. (c) Post-PTA shows mild improvement of the stenosis. (d) Placement of an 8 x 29 mm Carotid Wallstent Monorail. (e) Post-dilatation using a 4 mm x 40 mm SHIDEN balloon dilatation catheter. (f) Post-PTA showing the dilated stent. (g) A postprocedural common carotid angiogram reveals satisfactory revascularization.
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case_images: PMC11021079_01_SNI-15-91-g004.jpg
case_images: F4
case_images: Ultrasonography of the right carotid artery revealed a hyperechoic plaque within the stent, and routine carotid angiography revealed severe stenosis of the right cervical ICA [Figure 4a, white arrow]. A 3.5 x 20 mm NSE PTA balloon was then inflated in the lesion at 8 atm for 60 s, 8 atm for 60 s, and 14 atm for 60 s to achieve successful luminal expansion [Figures 4b and c]. An 8 x 29 mm Carotid Wallstent Monorail was deployed, and a 4 x 40 mm SHIDEN balloon dilatation catheter was inflated at 8 atm for 60 s as a post-dilatation step [Figures 4d-f]. Right common carotid angiography showed improved ICA flow [Figure 4g].
case_images: Postoperative magnetic resonance imaging, (a and b) diffusion-weighted image , and (c) magnetic resonance angiography showing no infarcts and improvement in the right cervical internal carotid artery stenosis.
case_images: SNI-15-91-g005.jpg
case_images: PMC11021079_01_SNI-15-91-g005.jpg
case_images: F5
case_images: No postprocedural stroke events occurred [Figure 5].