scholarly journals The impact of proximal cell rewiring compared with distal cell rewiring with single-stent deployment and subsequent kissing balloon inflation in the inadequate jailing of a Kaname stent on the side branch ostium

2018 ◽  
Vol 25 (3) ◽  
pp. 317-326
Author(s):  
Fumiaki Nakao
Keyword(s):  
Side Branch ◽  
Balloon Inflation ◽  
Stent Deployment ◽  
The Impact ◽  
Distal Cell

scholarly journals Inflation Pressure in Side Branch during Modified Jailed Balloon Technique Does Not Affect Side Branch Outcomes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Tetsuya Nomura ◽  
Naotoshi Wada ◽  
Issei Ota ◽  
Satoshi Tasaka ◽  
Kenshi Ono ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Coronary Intervention ◽  
Side Branch ◽  
Plaque Burden ◽  
Lesion Length ◽  
Inflation Pressure ◽  
Balloon Inflation ◽  
Stent Deployment ◽  
Main Vessel ◽  
Balloon Technique

Objectives. This study aimed to investigate the optimal jailed balloon inflation in the side branch during the modified jailed balloon technique for bifurcated lesions. Background. The modified jailed balloon technique is one of the effective techniques to minimize the emergence of side branch (SB) compromise by preventing plaque or carina shifting during a single stent strategy in the main vessel with provisional SB treatment. However, there are no detailed studies on the method of optimal jailed balloon inflation. Methods. We analyzed 51 consecutive patients who underwent percutaneous coronary intervention (PCI) for bifurcated lesions with a modified jailed balloon technique between September 2018 and December 2020. These 51 patients were divided into two groups according to the magnitude of inflation pressure of the jailed balloon: a higher pressure (HP) group and lower pressure (LP) group. Results. No significant differences in procedural outcomes were observed between the two groups. The findings of SB compromise were relatively common with our procedure (30.0% in the HP group; 33.3% in the LP group). The patterns of SB compromise such as dissection or stenosis increase were observed at similar frequencies between them. In particular, SB dissection was noted in the SB lesion with some plaque burden, irrespective of the magnitude of the jailed balloon inflation pressure. Univariate analysis showed that calcification in the main vessel and SB lesion length was significantly associated with SB compromise. Finally, all PCI procedures were successfully completed without any provisional stent deployment in SB. Conclusions. We speculate that lesion characteristics rather than the PCI procedural factors may be critical determinants to cause SB compromise.

Percutaneous Coronary Intervention for Complex Bifurcation Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 58
Author(s):  
Yves Louvard ◽  
Morice Marie-Claude ◽  
Thomas Hovasse ◽  
Thierry Lefèvre ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Drug Eluting Stents ◽  
Open Angle ◽  
Balloon Inflation ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Stent Diameter

Coronary bifurcations are prone to the development of atherosclerosis. They pose technical difficulties for angioplasty treatment and are a predictor of stent thrombosis and restenosis. Treatment of coronary bifurcations is still subject to debate, especially when the side branch (SB) is large, not easily accessible and narrowed by a long lesion. There is currently no indexed treatment for this type of lesion (Medina classification), as the strategy of provisional SB stenting with drug-eluting stents (DES) has proved to be equally efficient as the dualstent technique. Complex techniques are associated with poor outcome in certain lesion types, such as T-stenting when the angle between the two distal branches is small or the crush and culotte technique in the presence of an open angle. Provisional SB stenting may be used when primary dual stenting is required, with a low risk of failure provided that the following guidelines are implemented: stenting of the main branch through the protected SB with a stent diameter adapted to the distal main branch, immediate optimisation of the proximal stent segment (Finet’s law), guidewire exchange, kissing balloon inflation with non-compliant balloons selected according to the diameter of the distal branches and T-stenting of the SB before final kissing inflation.

scholarly journals In vitro Remote Aspiration Embolectomy for the Treatment of Acute Ischemic Stroke

2018 ◽  
Vol 8 (1) ◽  
pp. 20-26
Author(s):  
Asim Rizvi ◽  
Sean T. Fitzgerald ◽  
Kent D. Carlson ◽  
Dan Dragomir Daescu ◽  
Waleed Brinjikji ◽  
...  
Keyword(s):  
Case Series ◽  
In Vitro Study ◽  
Side Branch ◽  
Collateral Branch ◽  
Proximal Internal Carotid Artery ◽  
Glass Model ◽  
Catheter Tip ◽  
Inner Diameter ◽  
The Impact

Background: “Remote aspiration,” using suction from the proximal internal carotid artery (ICA) to open terminus occlusions, has been reported in small case series. However, it remains unclear whether remote aspiration is feasible for middle cerebral artery occlusions in the setting of potential inflow from communicating arteries. We performed an in vitro study to assess whether suction applied at various locations proximal to an occlusion could successfully aspirate the clot. Methods: A glass model of 4 mm inner diameter (ID) with 1 mm distal narrowing and 2 mm side branch to simulate a communicating artery was constructed. A proximal side branch was placed to simulate inflow from the proximal ICA. The impact of three different-sized catheters (ID 0.088, 0.070, and 0.056 in) on histologically different (red blood cell-cell rich, fibrin-rich, and mixed) clot analogues was tested with the catheter tip placed remotely either distal or proximal to the collateral branch. Aspiration was attempted with (1) open system (flow in both the ICA and the collateral branch, (2) flow arrest with open collateral (no flow in the ICA, but flow in the collateral branch), and (3) closed system (no flow in either the ICA or the collateral branch). The outcome was success or failure of remote aspiration. Results: For the 0.088-in catheter, remote aspiration was successful in all conditions. For the 0.070-in catheter, remote aspiration was unsuccessful without proximal flow arrest, but was successful in all other scenarios. For the 0.056-in catheter, remote aspiration was successful only with complete flow arrest. Conclusions: In a noncollapsible system, remote aspiration can be successfully achieved even in the setting of prominent branch arteries by using relatively large aspiration catheters. Proximal flow arrest may facilitate successful remote aspiration for some catheter sizes.

Optimal Balloon Inflation Pressures for Stent Deployment: High Pressure is Always Good?

1998 ◽  
Vol 28 (8) ◽  
pp. 1272 ◽  
Author(s):  
Eun Mi Lee ◽  
Dong Joo Oh ◽  
Hyun Chul Kim ◽  
Byung Hoe Kim ◽  
Soo Mi Kim ◽  
...  
Keyword(s):  
High Pressure ◽  
Balloon Inflation ◽  
Stent Deployment

scholarly journals A Case of an Obstructive Intramural Haematoma during Percutaneous Coronary Intervention Successfully Treated with Intima Microfenestrations Utilising a Cutting Balloon Inflation Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Osama Alsanjari ◽  
Aung Myat ◽  
James Cockburn ◽  
Grigoris V. Karamasis ◽  
David Hildick-Smith ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Intervention ◽  
Intramural Haematoma ◽  
Balloon Inflation ◽  
Cutting Balloon ◽  
Stent Deployment ◽  
Stent Expansion ◽  
Percutaneous Coronary

During percutaneous coronary interventions (PCI), good lesion preparation with adequate balloon predilatation is a fundamental step before stent deployment in order to achieve optimal stent expansion and favourable long-term outcomes post PCI. During PCI, inadvertent vessel tearing can occur, resulting in coronary dissections and formation of intramural haematomas. The latter might be associated with compression of the vessel lumen and significant compromise of the coronary blood flow leading to myocardial ischaemia and infarction. Herein, we present a case of intramural haematoma that occurred after PCI of the left anterior descending artery resulting in occlusion of the vessel and the subsequent use of a cutting balloon inflation technique to resolve the haematoma and restore the normal coronary blood flow.

Duration of balloon inflation for optimal stent deployment: Five Seconds Is Not Enough

2012 ◽  
Vol 81 (3) ◽  
pp. 446-453 ◽  
Author(s):  
Thomas Hovasse ◽  
Darren Mylotte ◽  
Philippe Garot ◽  
Neus Salvatella ◽  
Marie-Claude Morice ◽  
...  
Keyword(s):  
Balloon Inflation ◽  
Stent Deployment
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