Abstract: In recent years, the transforearm vascular approach such as radial artery approach has been widely used, but some patients cannot continue the radial artery approach due to congenital slender radial artery, radial artery stenosis or even occlusion after previous repeated radial artery punctures. In this case, the patient required interventional therapy for severe stenosis at the origin of the left internal carotid artery. The patient has a bovine aortic arch, which is suitable for the radial artery approach surgery. However, the patient had undergone several previous operations via the radial artery approach, resulting in a slender radial artery, and further radial artery approach for interventional therapy cannot be completed. The color Doppler ultrasonography found that the diameter of ulnar artery was thick enough for puncture and sheath placement. Therefore, this study tried to perform digital subtraction angiography and carotid artery stenting through ulnar artery approach. The operation was successfully completed without complications, providing a reference for the interventional surgery via ulnar artery approach.

Key words: Ulnar artery approach; Carotid artery stenosis; Digital subtraction angiography; Carotid artery stenting

摘要： 近年来经前臂血管入路如桡动脉入路行神经介入治疗已被广泛应用，但部分患者因先天性桡动脉纤细或既往多次桡动脉穿刺后引起桡动脉狭窄甚至闭塞而无法继续经桡动脉入路完成治疗。本病例中患者因左侧颈内动脉起始部重度狭窄需进行介入治疗，其主动脉弓为牛角弓型，适合经桡动脉入路完成手术，然而该患者因既往多次经桡动脉入路进行手术，导致桡动脉纤细，无法进一步完成经桡动脉入路介入治疗。彩超检查发现患者尺动脉直径粗，能耐受彩超置入血管鞘，因此本研究尝试经尺动脉入路完成脑血管造影及颈动脉支架置入术。该患者手术顺利，无并发症发生，为后续经尺动脉入路行神经介入及治疗的研究提供参考。

关键词: 经尺动脉入路; 颈动脉狭窄; 全脑血管造影术; 颈动脉支架置入术