{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:00:42Z","timestamp":1786125642849,"version":"build-2736575974"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Endovascular intervention has become the mainstay of treatment for subclavian artery stenosis in many centers, with high technical success and low complication rates.\n                    <jats:sup>1<\/jats:sup>\n                    <jats:sup>,<\/jats:sup>\n                    <jats:sup>2<\/jats:sup>\n                    However, potential embolization during proximal subclavian artery intervention can lead to catastrophic posterior circulation ischemic complications.3\u20135\n                    <jats:sup>-<\/jats:sup>\n                    <jats:sup>5<\/jats:sup>\n                    Although considered a rare complication, the presence of a contralateral hypoplastic vertebral artery with persisting anterograde vertebral blood flow on the affected side is likely to increase the risk of embolization.\n                    <jats:sup>3<\/jats:sup>\n                    The use of embolic protection devices, such as filters and noncompliant balloons, has been previously described.\n                    <jats:sup>3<\/jats:sup>\n                    <jats:sup>,<\/jats:sup>\n                    <jats:sup>6<\/jats:sup>\n                    <jats:sup>,<\/jats:sup>\n                    <jats:sup>7<\/jats:sup>\n                    However, there is still a risk of distal embolization and vessel injury with the use of these devices.\n                    <jats:sup>7<\/jats:sup>\n                    We present a technical video of a patient in their 80s with left subclavian stenosis who underwent subclavian stent-assisted percutaneous transluminal angioplasty (SAPTA) using an anterograde-retrograde access technique with a dual-lumen compliant balloon catheter (Scepter XC; MicroVention, Aliso Viejo, California) placed at the proximal segment of the left vertebral artery. With this approach, the compliant balloon provides adequate protection while minimizing the risk of endothelial injury and distal embolization.\n                  <\/jats:p>\n                  <jats:p>Written informed consent was obtained for the procedure. Patient consent was waived because all health information was deidentified.<\/jats:p>","DOI":"10.1093\/ons\/opaa470","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T18:33:17Z","timestamp":1611426797000},"page":"E376-E377","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"20","author":[{"given":"Aldo A","family":"Mendez","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Mendez-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Fakih","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mudassir","family":"Farooqui","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeepta","family":"Dandapat","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Ortega-Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,5]]},"reference":[{"issue":"6","key":"bib1-20251027","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1016\/j.jvs.2016.12.098","article-title":"Validation of subclavian duplex velocity criteria to grade severity of subclavian artery stenosis","volume":"65","author":"Mousa","year":"2017","journal-title":"J Vasc Surg"},{"key":"bib2-20251027","doi-asserted-by":"crossref","first-page":"254.e1","DOI":"10.1016\/j.avsg.2017.11.033","article-title":"Primary stenting of right-sided subclavian artery stenosis presenting as subclavian steal syndrome: report of 3 cases and literature review","volume":"48","author":"Sahsamanis","year":"2018","journal-title":"Ann Vasc Surg"},{"issue":"5","key":"bib3-20251027","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jvir.2010.12.038","article-title":"Subclavian artery endovascular intervention for vertebrobasilar ischemia: the use of dual arterial access and embolic protection","volume":"22","author":"Rahim","year":"2011","journal-title":"J Vasc Interv Radiol"},{"issue":"3","key":"bib4-20251027","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1177\/1538574416638758","article-title":"Distal embolization during percutaneous subclavian artery intervention","volume":"50","author":"Alkhouli","year":"2016","journal-title":"Vasc Endovascular Surg"},{"issue":"8","key":"bib5-20251027","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.avsg.2011.03.017","article-title":"Long-term results of 81 prevertebral subclavian artery angioplasties: a 26-year experience","volume":"25","author":"Berger","year":"2011","journal-title":"Ann Vasc Surg"},{"key":"bib6-20251027","doi-asserted-by":"crossref","first-page":"709.e5","DOI":"10.1016\/j.wneu.2017.02.018","article-title":"Feasibility and safety of distal and proximal combined endovascular approach with a balloon-guiding catheter for subclavian artery total occlusion","volume":"100","author":"Yamamoto","year":"2017","journal-title":"World Neurosurg"},{"issue":"2","key":"bib7-20251027","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s12928-014-0271-7","article-title":"Subclavian artery intervention with a balloon-tipped occlusion catheter via the ipsilateral brachial artery without an introducer sheath","volume":"30","author":"Nakamura","year":"2015","journal-title":"Cardiovasc Interv Ther"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/20\/5\/E376\/37041571\/opaa470.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa470","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:59:33Z","timestamp":1786121973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa470"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,20]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opaa470","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,20]]},"assertion":[{"value":"2020-07-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}