Carotid Artery Approach as an Alternative to Femoral access for Balloon Dilation of Aortic Valve Stenosis in Neonates and Infants

Abstract

Our experience confirms that the carotid access proposed in 1973 by Azzolina et al is a valid and safe alternative to the usual percutaneous femoral access. In particular it could be useful in neonates and infants were the size of femoral vessels could facilitate important and dangerous complications.

Balloon aortic valvuloplasty for congenital aortic stenosis using the femoral and the carotid artery approach: A 16‐year experience from a single center

“…This likely explains the high incidence of vascular complications, similar to those described in the first reported studies, and cannot be compared with more recent reports in which the same approach was used. The absence of vascular complications seen in patients undergoing carotid surgical cut‐down in this study correlates with previous reports using the same approach [32, 33]. Currently, it seems reasonable to support the carotid artery approach as a good alternative when performing BAVP in newborns, considering individual variations at different institutions.…”

Percutaneous Common Carotid Artery Access for Pediatric Interventional Cardiac Catheterization

“…Given that the neonatal carotid artery is larger in diameter than the femoral artery, [16][17][18] carotid access may play an important role in preventing the complications of femoral artery thrombosis when applied to this higher risk infant population. However, to help justify accessing the carotid artery to spare the femoral artery, the relative risk and relative consequence of occluding each of these vessels should ideally be known.…”

Primary coronary stent implantation is a feasible bridging therapy to surgery in very low birth weight infants with critical aortic coarctation

“…Carotid artery access was not performed to avoid possible risks on carotid trauma or cerebral embolism in these small vessel patients. Recent data show that surgical cutdown [16] and percutaneous [17] carotid artery access are relatively safe alternatives to percutaneous femoral access in neonates and infants. However, carotid artery thrombosis has been observed in these series with unknown effects on brain injury and outcome.…”