E-350 Advanced fusion imaging guided non-standard sentinel cerebral protection device deployment within brachiocephalic branches during angioplasty and stent placement- a novel approach

Introduction The expanding complexity of cerebrovascular interventions has necessitated the need for advancement of novel imaging technologies for the safety and accuracy of the percutaneous interventions. Application of complementary advanced fusion imaging is a novel technology that ensures the benefits of utilizing dual modalities of multi-detector computed tomography with the real-time two-dimensional (2D) fluoroscopy images for better results while ensuring accuracy.Material/Methods Results A 65-year-old male with multiple comorbidities who presented with a syncopal attack while driving, resulting in MVA down a ravine. Further workup with CT angiography showed a severe narrowing of the proximal brachiocephalic trunk due to atherosclerosis, and carotid USG finding suggested a possible subclavian steal syndrome. Non-standard trans arterial SENTINEL cerebral embolic device deployment within brachiocephalic branches along with angioplasty and stent placement was performed under advanced fusion imaging resulting successful complete recanalization of the brachiocephalic vessel without any neurological deficits.Conclusion The current study is the first of its kind to utilize the advanced fusion, demonstrating its safety and feasibility during the deployment of SENTINEL device only in brachiocephalic branches with percutaneous angioplasty and stent deployment with minimal usage of intravenous contrast.Disclosures A. Shahid: None. A. Ebrahimi: None. M. Saify: None. M. Alkhawam: None. M. Ahmed: None.Abstract E-350 Figure 1