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利用球囊锚定技术提高支架血管成形术治疗粥样硬化性肾动脉狭窄的器械输送能力。

Utilizing the balloon anchoring technique to improve device deliverability during stent revascularization for atherosclerotic renal artery stenosis.

机构信息

Department of Cardiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.

出版信息

Vascular. 2023 Dec;31(6):1209-1213. doi: 10.1177/17085381221112549. Epub 2022 Jul 4.

Abstract

INTRODUCTION

The stent revascularization for severely calcified renal artery lesions can be challenging, due to a deficiency in back-up force provided by the guide catheter. The aim of this report is to describe the use of the balloon anchoring technique to increase device maneuverability and deliverability after the failure of conventional renal artery revascularization.

TECHNICAL NOTE

This technique was adopted in a patient with subtotal occlusive and severely calcified lesion in the proximal portion of the right main renal artery Two guidewires were separately introduced into the proximal side branch (SB) and main branch (MB) of the renal artery. Anchor balloon inflated at low pressure in SB, anchoring the MB-wire and the guide catheter, thus giving us the ability to cross the tight calcified proximal cap of the MB lesion with a non-compliant balloon. After performing pre-dilatations and retrieving the anchor balloon, we implanted a balloon-expandable stent and achieved optimal final angiographic results.

CONCLUSIONS

The balloon anchoring technique can improve device maneuverability and deliverability during various catheterization procedures. Our report firstly demonstrates how to perform the balloon anchoring technique in renal angioplasty treatment and then explains its effectiveness in revascularization of the renal artery with challenging anatomies.

摘要

介绍

由于导引导管提供的支撑力不足,严重钙化的肾动脉病变的支架血管成形术可能具有挑战性。本报告的目的是描述在常规肾动脉血运重建失败后,使用球囊锚定技术增加器械的可操作性和可输送性。

技术说明

该技术应用于一名患者,该患者右主肾动脉近段有次全闭塞和严重钙化病变。两条导丝分别引入肾动脉的近侧分支(SB)和主支(MB)。在 SB 中低压膨胀锚定球囊,固定 MB 导丝和导引导管,从而使我们能够使用非顺应性球囊穿过 MB 病变的紧密钙化近端帽。在进行预扩张和取回锚定球囊后,我们植入了球囊扩张支架,并获得了最佳的最终血管造影结果。

结论

球囊锚定技术可提高各种导管插入术过程中的器械可操作性和可输送性。我们的报告首先演示了如何在肾血管成形术中进行球囊锚定技术,然后解释了其在具有挑战性解剖结构的肾动脉血运重建中的有效性。

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