Transseptal approach for stent implantation in right internal carotid artery stenosis

Carotid artery stenting is emerging as an effective measure to prevent stro kes in patients with significant carotid artery stenosis, We report a case of right internal carotid artery stenosis in which we used a transseptal ap proach for successful carotid artery stenting. This patient had concomitant stenosis at all three coronary arteries, including the left main coronary artery, A transseptal approach was adopted due to the sharply angled take-o ff of the right brachiocephalic artery from the tortuous aortic arch, where advancement of an extra-stiff wire into the right common carotid artery wa s not possible by a femoral artery approach.