Balloon Angioplasty of Lesions Beyond Extremely Angulated Bends

Angioplasty of stenosis beyond severely angulated bends (acute angle less than 60¡) can be technically difficult. In addition to the difficulty traversing these severe bends with a guidewire, once crossed, even the lowest profile over-the-wire balloon catheter may not advance around these severe angulations. The utility of fixed-wire balloon catheters is often limited by prolapse of the distal wire tip. We describe a technique of shaping a fixed-wire balloon catheter to prevent wire prolapse while traversing severely angulated bends and its successful use in two consecutive cases where conventional methods failed.