The direct carotid approach in patients with AIS and coarctation of the aorta has been reported as a successful procedure in the literature so far, only by Roche et al. [39], who performed direct right common carotid puncture following the administration of the intravenous tissue plasminogen activator, in a 73-year-old woman with a large aortic arch saccular aneurysm measuring approximately 8 cm. The gene discussed is PLAT; the disease is androgen insensitivity syndrome.