Department of Neurology, the Affiliated Hospital of University of Electronic Science and Technology, Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
Department of Neurology, the Affiliated Hospital of University of Electronic Science and Technology, Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
World Neurosurg. 2019 Jun;126:616-618. doi: 10.1016/j.wneu.2019.03.018. Epub 2019 Mar 12.
This is new research about the technology for navigating a catheter that is eccentric or tangentially angled to the long axis of a carotid artery stent. In our clinical practice, we found resistance when the 8-French guiding catheter crossed the balloon, even when it was partially expanded. Therefore we intended to improve the operating procedure by using a smaller balloon with a diameter of 2 mm. The smaller balloon can navigate the guiding catheter to reaccess the angled junction with minimal resistance after it is fully expanded.
We applied the small balloon bridge technology in 1 case of left internal carotid artery stent implantation. After the stents were released successfully, we found that it was difficult to recapture an umbrella because the guiding catheter had a steep angle to the long axis of carotid artery with released stents. To overcome this obstacle, we sent a 2-mm balloon into the tip of the catheter and then inflated it fully. Therefore the steep angle could be straightened due to the expanded balloon playing a supportive effect. As a result, the guiding catheter reaccessed the previous angled junction smoothly as the small balloon moved forward and recaptured the umbrella successfully.
Using the small balloon bridge technique to navigate the guiding catheter is a safer, simpler, and more effective operation for carotid interventional therapy. Furthermore, it might also be applied to other endovascular treatments that require guiding catheters for intervention.
这是一项关于引导导管偏心或切线角度进入颈动脉支架长轴的导航技术的新研究。在我们的临床实践中，当 8 French 引导导管穿过球囊时，即使球囊部分扩张，我们也会发现阻力。因此，我们打算通过使用直径为 2 毫米的更小的球囊来改进操作程序。在完全扩张后，较小的球囊可以导航引导导管以最小的阻力重新进入成角的交界处。
我们在 1 例左颈内动脉支架植入术中应用了小气球桥技术。支架释放成功后，我们发现由于释放后的支架使引导导管与颈动脉长轴形成陡峭的角度，很难重新捕获保护伞。为了克服这个障碍，我们将 2 毫米的球囊送入导管尖端，然后完全充气。因此，由于膨胀的球囊起到支撑作用，陡峭的角度可以变直。结果，随着小气球向前移动并成功捕获保护伞，引导导管顺利重新进入先前的成角交界处。
使用小气球桥技术引导导管是一种更安全、更简单、更有效的颈动脉介入治疗操作。此外，它也可能应用于其他需要引导导管介入的血管内治疗。
