Key result
Ultrasound-guided STA cannulation enables continuous perfusion monitoring during carotid clamping in transcarotid TAVR.
Why the study?
TC-TAVR requires common carotid artery clamping, but standard rSO2 cerebral perfusion monitoring is limited by extracranial contamination.
Does superficial temporal artery pressure monitoring provide useful collateral perfusion information during transcarotid transcatheter aortic valve replacement?
Case Report (n=1)
No
Does superficial temporal artery pressure monitoring provide useful collateral perfusion information during transcarotid transcatheter aortic valve replacement?
Ultrasound-guided superficial temporal artery pressure monitoring is a feasible adjunct to regional cerebral oxygen saturation for assessing collateral cerebral perfusion during transcarotid TAVR.
STA pressure monitoring may complement rSO2 during TC-TAVR; hypothesis-generating and requires prospective validation before clinical use.
Background Transcarotid transcatheter aortic valve replacement (TC-TAVR) requires common carotid artery (CCA) clamping, necessitating cerebral perfusion monitoring. Regional cerebral oxygen saturation (rSO 2 ) is widely used but limited by extracranial contamination. Superficial temporal artery (STA) pressure monitoring may reflect collateral perfusion pressure distal to the clamp because of ipsilateral internal carotid artery (ICA)–STA continuity during CCA clamping. Case presentation An 80-year-old man with severe aortic stenosis underwent TC-TAVR via the left CCA. Under ultrasound guidance, we placed a 24-gauge catheter in the left STA to monitor collateral perfusion pressure during CCA clamping. STA mean arterial pressure (MAP) decreased from 81 to 35 mmHg upon CCA clamping and was targeted at ≥ 40 mmHg with norepinephrine, except during rapid pacing for valve deployment. He was discharged on postoperative day 5 uneventfully. Conclusions STA pressure may provide supplementary collateral perfusion information to rSO 2 during CCA clamping, and ultrasound-guided STA cannulation was feasible.
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Awaya et al. (2026) conducted a case report in Severe aortic stenosis (n=1). Superficial temporal artery pressure monitoring was evaluated on Feasibility and utility of STA pressure monitoring. Ultrasound-guided superficial temporal artery cannulation was feasible and provided continuous collateral perfusion pressure monitoring during common carotid artery clamping in transcarotid transcatheter aortic valve replacement.
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