Zenith devices used in this case:

Patient Information

• Male, 76 years old
• Paroxysmal blurred vision in the right eye and left limb weakness for 4.5 hours
• Muscle strength: 5/5 in all limbs
• Positive Romberg sign

Preoperative Angiography

Head DWI:

Head MRA:

Procedure

DSA：a Type III aortic arch; femoral access was difficult.

Angiography of the left ICA and left vertebral artery was performed.

Severe stenosis with near-occlusion at the origin of the right ICA; moderate stenosis at the origin of the right MCA.

Transradial access established; a 6F Zenith Delivery Catheter was smoothly advanced to the common carotid artery.

Embolic protection device was deployed with good wall apposition confirmed by angiography, followed by pre-dilation with a 3.0 × 20 mm balloon.

An 8 × 30 mm Precise stent was delivered through the Zenith Delivery Catheter, easily navigating the tortuous proximal CCA segment, and deployed successfully after proper positioning.

Retrieval of the embolic protection device assisted by neck rotation.

Postoperative Angiography

The stent in the right ICA was well apposed with smooth antegrade blood flow.

Postoperative Comments

• In this case, due to the Type III aortic arch, femoral access was difficult.
• The 6F Zenith Delivery Catheter, with an outer diameter of only 2.20 mm, fits through a 6F radial sheath, minimizing radial artery spasm and delayed occlusion. Its segmental design optimized for transradial access provides stronger arch support. The catheter can also pass through a 5F intermediate catheter if needed for additional interventions.
• Thanks to the Zenith Delivery Catheter's structural features, transradial access enabled smooth navigation through the tortuous proximal CCA with excellent support and high positioning accuracy.

Surgeon Information

Zhiyi Liu, Honghao Li and Hongru Deng, The First People's Hospital of Shenyang