Novel use of the ENROUTE transcarotid arterial sheath for antegrade cerebral perfusion during retrograde innominate stenting

Femoral-carotid bypass has been described to preserve antegrade cerebral perfusion during aortic arch and great vessel interventions. We describe a novel use of the ENROUTE transcarotid arterial sheath (Silk Road Medical, Sunnyvale, Calif) as the outflow component of a femoral-carotid shunt for maintenance of antegrade cerebral perfusion during a retrograde innominate stenting procedure. We discuss the unique advantages of this sheath for use in this application.