Two-wire (0.014 & 0.018-inch) technique to facilitate innominate artery stenting under embolic protection

Evan J. Ryer, Gustavo S. Oderich

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Purpose: To describe a 2-wire technique for innominate artery stent placement under embolic protection. Technique: Confronted with a high-grade innominate artery stenosis that blocked passage of a 0.035-inch stent delivery system from the femoral approach, a 0.018-inch guidewire was advanced in retrograde fashion via the right radial artery and captured via the femoral approach, establishing right radial-femoral through-and-through access. The 0.018-inch guidewire provided excellent support for positioning an 8-F hydrophilic sheath at the origin of the innominate artery. A 0.035-inch catheter was used to cross the lesion from the femoral approach, and a 0.014-inch buddy wire was introduced into the right common carotid artery. A 7-mm SpideRX filter was then deployed over the 0.014-inch guidewire. The 2-wire combination was used to load a 0.035-inch-compatible balloon-expandable stent system, which was deployed in the innominate artery and flared proximally, with excellent angiographic result. Conclusion: This technique provided excellent support in difficult anatomy while enabling use of a 0.035-inch-compatible stent and embolic protection. It has also been applied in the subclavian artery with protection of the vertebral or internal mammary artery and for lower extremity interventions.

Original languageEnglish (US)
Pages (from-to)652-656
Number of pages5
JournalJournal of Endovascular Therapy
Issue number5
StatePublished - Oct 1 2010


  • Buddy wire
  • Embolic protection device
  • Innominate artery
  • Radial artery access
  • Stenosis
  • Stent
  • Through-and-through wire
  • Vascular access

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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