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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.

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Operation process of the patient performed with the new technique.A: CAG showed completely obstruction in the proximal RCA. B: The microcatheter advanced into the distal part of the RCA through the CTO lesion. C: The microcatheter was withdrew within the guide catheter (at the end of the the ascending aorta). The balloon was dilated with 8–10atm when the predilation balloon was inserted 2–3cm distal the microcatheter to fix the guidewire at the inside wall of the guide catheter. The microcatheter was withdrawn slowly with no shifting of the guidewire. D: CAG after the operation showed no stenosis in the distal vessels of RCA and TIMI 3 flow.
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f02: Operation process of the patient performed with the new technique.A: CAG showed completely obstruction in the proximal RCA. B: The microcatheter advanced into the distal part of the RCA through the CTO lesion. C: The microcatheter was withdrew within the guide catheter (at the end of the the ascending aorta). The balloon was dilated with 8–10atm when the predilation balloon was inserted 2–3cm distal the microcatheter to fix the guidewire at the inside wall of the guide catheter. The microcatheter was withdrawn slowly with no shifting of the guidewire. D: CAG after the operation showed no stenosis in the distal vessels of RCA and TIMI 3 flow.


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)

Operation process of the patient performed with the new technique.A: CAG showed completely obstruction in the proximal RCA. B: The microcatheter advanced into the distal part of the RCA through the CTO lesion. C: The microcatheter was withdrew within the guide catheter (at the end of the the ascending aorta). The balloon was dilated with 8–10atm when the predilation balloon was inserted 2–3cm distal the microcatheter to fix the guidewire at the inside wall of the guide catheter. The microcatheter was withdrawn slowly with no shifting of the guidewire. D: CAG after the operation showed no stenosis in the distal vessels of RCA and TIMI 3 flow.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4585439&req=5

f02: Operation process of the patient performed with the new technique.A: CAG showed completely obstruction in the proximal RCA. B: The microcatheter advanced into the distal part of the RCA through the CTO lesion. C: The microcatheter was withdrew within the guide catheter (at the end of the the ascending aorta). The balloon was dilated with 8–10atm when the predilation balloon was inserted 2–3cm distal the microcatheter to fix the guidewire at the inside wall of the guide catheter. The microcatheter was withdrawn slowly with no shifting of the guidewire. D: CAG after the operation showed no stenosis in the distal vessels of RCA and TIMI 3 flow.

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.


Related in: MedlinePlus