Percutaneous direct carotid puncture using an elastic needle for coil embolization of a ruptured cerebral aneurysm with right-sided aortic arch and carotid stenosis: illustrative case.

When conventional endovascular access is precluded by complex vascular anatomy, particularly in cases complicated by carotid artery stenosis, direct carotid puncture using an elastic needle may offer a safer and less invasive alternative. This approach provides a feasible option in anatomically challenging situations in which standard sheaths would increase the risk of ischemic complications. https://thejns.org/doi/10.3171/CASE25869.