A potential pitfall in the use of the monorail system for carotid stenting. A technical case report

The use of EPDs seems to be necessary for safe CAS. Though the monorail system may offer advantages for a single operator, we caution its use with certain aortic arch anatomies. In such anatomies, using an OTW system or at least a 300 cm filter wire or devices that support wire extension will remedy some complications, such as the loss of the guiding sheath. As in our case, the added advantage ora 300 cm filter wire enabled us to avoid a poor outcome or an emergency vascular surgery.