Reentry Technique for Rescue Recanalization of Carotid Near-Total Occlusion after Subintimal Penetration

ABSTRACT

Carotid stent placement is an effective alternative for stroke prevention in patients with carotid stenosis. However, endovascular recanalization of near-total carotid occlusion remains challenging, with subintimal dissection sometimes unavoidable. We present the case of an adult in their 70s with symptomatic carotid stenosis. During plaque crossing with a microwire, unintentional subintimal dissection occurred. The reentry technique, using a specialized reentry catheter, was performed, followed by carotid stent placement, achieving successful recanalization. The patient made a good clinical recovery. In selected cases, subintimal recanalization of carotid occlusion using the rescue re-entry technique can be performed safely after entry into the false lumen.^1⇓⇓⇓-5