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A simple practical balloon anchoring technique within the guide catheter for chronic total occlusion (CTO) of the coronary artery.

Chen L, Cheng Y, Yang Y, Zhang Z, Zhang D, Wang L - J Biomed Res (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .

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Dear Editor: Chronic total occlusions (CTOs) of the coronary artery are commonly encountered complex lesions... To overcome the previous problem, we designed a new technique for withdrawing the microcatheter: the balloon anchoring technique within the guide catheter... After the wire is proved to locate in the ture lumen of blood vessel by the contrast agent injected from the microcatheter, the wire is advanced into the occluded segment. (2) Withdraw the microcatheter several centimeters in the guide catheter (probably at the end of ascending aorta). (3) Insert a predilation balloon with diameter ranged from 2.0-2.5mm (the balloon can be used in percutaneous transluminal coronary angioplasty (PTCA) afterwards)into the distal end of the catheter via the guide catheter on the outside of the microcatheter. (4) Release the balloon with pressure ranged from 8 to 10atm and press the guidewire on the wall of the guide catheter, then withdraw the microcatheter with slow and uniform speed under X-ray fluoroscopy. (5) Withdraw the predilation balloon gradually when the microcatheter is completely removed... Coronary angiography showed a CTO of the proximal right coronary artery (RCA)... No stenosis was found in LM... A 2.25*18mm ENDEAVOR stent was successfully implanted at the lesion after a 2.0*15mm SPRINTER balloon predialation... The operation was successful and the patient returned to the ward safely... In the technique we introduce here, the guidewire is anchored at the inside wall of guide catheter with 8-10atm produced by the balloon... Besides, anchor point is near the distal wire, which decreases the possibility of the distal wire shifting... Moreover, the speed of withdrawing the microcatheter is faster with the introduced technique than that with traditional technique. (2) Compared with the technique that using prolonged wire (such as RG3) at the beginning of the operation, the time that the technique costs is decreased because of the short wire, decreasing X-ray exposure time and contrast agent dosage. (3) The operator does not need to press the proximal guidewire... The operator can withdraw the microcatheter with one hand, and fix the guide catheter with the other hand, reducing the possibility of guide catheter shifting and the difficulty of operation, meanwhile increasing the operation safety... In summary, the balloon anchoring technique within the guide catheter could withdraw the microcatheter faster and more convenient, reduce the operation time, contrast agent dosage, X-ray exposure time, the difficulty of operation and the occurrence of complications, the guidewire shifting... The technique is simple, safe and effective for CTO-PCI operators, and it is why we decide to promote the technique.

No MeSH data available.


Detailed steps of the new technique for withdrawing the microcatheter.A: The microcatheter is withdrawn to the end of the ascending aorta. The predilation balloon is advanced into the distal microcatheter alongside the guide catheter. B: Release the predilation balloon at 8–10atm. The guidewire is anchored at the wall of the guide catheter to fix the guidewire and then the microcatheter is withdrawn.
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f01: Detailed steps of the new technique for withdrawing the microcatheter.A: The microcatheter is withdrawn to the end of the ascending aorta. The predilation balloon is advanced into the distal microcatheter alongside the guide catheter. B: Release the predilation balloon at 8–10atm. The guidewire is anchored at the wall of the guide catheter to fix the guidewire and then the microcatheter is withdrawn.

Mentions: To overcome the previous problem, we designed a new technique for withdrawing the microcatheter: the balloon anchoring technique within the guide catheter. Detailed steps are as follows: (1) Insert the guidewire into the occluded segment in support of the microcatheter and insert the microcatheter into the occluded segment alongside the wire. Remove the wire when it has arrived at distal vascular lesions through the occluded segment the wire. After the wire is proved to locate in the ture lumen of blood vessel by the contrast agent injected from the microcatheter, the wire is advanced into the occluded segment. (2) Withdraw the microcatheter several centimeters in the guide catheter (probably at the end of ascending aorta). (3) Insert a predilation balloon with diameter ranged from 2.0-2.5mm (the balloon can be used in percutaneous transluminal coronary angioplasty (PTCA) afterwards)into the distal end of the catheter via the guide catheter on the outside of the microcatheter (Fig. 1A). (4) Release the balloon with pressure ranged from 8 to 10atm and press the guidewire on the wall of the guide catheter, then withdraw the microcatheter with slow and uniform speed under X-ray fluoroscopy (Fig. 1B). (5) Withdraw the predilation balloon gradually when the microcatheter is completely removed.


A simple practical balloon anchoring technique within the guide catheter for chronic total occlusion (CTO) of the coronary artery.

Chen L, Cheng Y, Yang Y, Zhang Z, Zhang D, Wang L - J Biomed Res (2015)

Detailed steps of the new technique for withdrawing the microcatheter.A: The microcatheter is withdrawn to the end of the ascending aorta. The predilation balloon is advanced into the distal microcatheter alongside the guide catheter. B: Release the predilation balloon at 8–10atm. The guidewire is anchored at the wall of the guide catheter to fix the guidewire and then the microcatheter is withdrawn.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4585439&req=5

f01: Detailed steps of the new technique for withdrawing the microcatheter.A: The microcatheter is withdrawn to the end of the ascending aorta. The predilation balloon is advanced into the distal microcatheter alongside the guide catheter. B: Release the predilation balloon at 8–10atm. The guidewire is anchored at the wall of the guide catheter to fix the guidewire and then the microcatheter is withdrawn.
Mentions: To overcome the previous problem, we designed a new technique for withdrawing the microcatheter: the balloon anchoring technique within the guide catheter. Detailed steps are as follows: (1) Insert the guidewire into the occluded segment in support of the microcatheter and insert the microcatheter into the occluded segment alongside the wire. Remove the wire when it has arrived at distal vascular lesions through the occluded segment the wire. After the wire is proved to locate in the ture lumen of blood vessel by the contrast agent injected from the microcatheter, the wire is advanced into the occluded segment. (2) Withdraw the microcatheter several centimeters in the guide catheter (probably at the end of ascending aorta). (3) Insert a predilation balloon with diameter ranged from 2.0-2.5mm (the balloon can be used in percutaneous transluminal coronary angioplasty (PTCA) afterwards)into the distal end of the catheter via the guide catheter on the outside of the microcatheter (Fig. 1A). (4) Release the balloon with pressure ranged from 8 to 10atm and press the guidewire on the wall of the guide catheter, then withdraw the microcatheter with slow and uniform speed under X-ray fluoroscopy (Fig. 1B). (5) Withdraw the predilation balloon gradually when the microcatheter is completely removed.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor: Chronic total occlusions (CTOs) of the coronary artery are commonly encountered complex lesions... To overcome the previous problem, we designed a new technique for withdrawing the microcatheter: the balloon anchoring technique within the guide catheter... After the wire is proved to locate in the ture lumen of blood vessel by the contrast agent injected from the microcatheter, the wire is advanced into the occluded segment. (2) Withdraw the microcatheter several centimeters in the guide catheter (probably at the end of ascending aorta). (3) Insert a predilation balloon with diameter ranged from 2.0-2.5mm (the balloon can be used in percutaneous transluminal coronary angioplasty (PTCA) afterwards)into the distal end of the catheter via the guide catheter on the outside of the microcatheter. (4) Release the balloon with pressure ranged from 8 to 10atm and press the guidewire on the wall of the guide catheter, then withdraw the microcatheter with slow and uniform speed under X-ray fluoroscopy. (5) Withdraw the predilation balloon gradually when the microcatheter is completely removed... Coronary angiography showed a CTO of the proximal right coronary artery (RCA)... No stenosis was found in LM... A 2.25*18mm ENDEAVOR stent was successfully implanted at the lesion after a 2.0*15mm SPRINTER balloon predialation... The operation was successful and the patient returned to the ward safely... In the technique we introduce here, the guidewire is anchored at the inside wall of guide catheter with 8-10atm produced by the balloon... Besides, anchor point is near the distal wire, which decreases the possibility of the distal wire shifting... Moreover, the speed of withdrawing the microcatheter is faster with the introduced technique than that with traditional technique. (2) Compared with the technique that using prolonged wire (such as RG3) at the beginning of the operation, the time that the technique costs is decreased because of the short wire, decreasing X-ray exposure time and contrast agent dosage. (3) The operator does not need to press the proximal guidewire... The operator can withdraw the microcatheter with one hand, and fix the guide catheter with the other hand, reducing the possibility of guide catheter shifting and the difficulty of operation, meanwhile increasing the operation safety... In summary, the balloon anchoring technique within the guide catheter could withdraw the microcatheter faster and more convenient, reduce the operation time, contrast agent dosage, X-ray exposure time, the difficulty of operation and the occurrence of complications, the guidewire shifting... The technique is simple, safe and effective for CTO-PCI operators, and it is why we decide to promote the technique.

No MeSH data available.