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A Rat Carotid Balloon Injury Model to Test Anti-vascular Remodeling Therapeutics
Published on: September 19, 2016
Simulation Study of Distal Balloon Protection Systems during Carotid Artery Stenting
T Kuroiwa1, N Sakai, M Sakaguchi
1Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation; Kobe, Hyogo, Japan.
Summary
Distal balloon protection systems may fail during carotid artery stenting (CAS) if the GuardWire Plus balloon moves or the aspiration catheter is misplaced. This can lead to distal embolization, even with protective devices in place.
Area of Science:
- Biomedical Engineering
- Medical Device Simulation
- Vascular Surgery
Background:
- Cerebrovascular stenting procedures require effective embolic protection.
- Distal balloon protection systems aim to prevent debris migration during stenting.
Purpose of the Study:
- To evaluate potential failure modes of distal balloon protection systems.
- To identify technique optimizations for enhancing safety during carotid artery stenting (CAS).
Main Methods:
- Simulated carotid artery stenting using silicone models and a circulatory system.
- Utilized the PercuSurge GuardWire Plus (GWP) for balloon occlusion and an Export catheter for debris aspiration.
- Experimentally assessed debris movement with simulated GWP balloon deflation and varied aspiration catheter placement.
Main Results:
- A crevice between the GWP balloon and vessel wall allowed debris to concentrate and migrate distally.
- Aspiration catheter effectiveness decreased significantly as the distance from the GWP balloon increased.
- Optimal debris aspiration occurred when the catheter tip was placed immediately below the occluding balloon.
Conclusions:
- Accidental GWP balloon movement during CAS can compromise protection.
- Improper placement of the aspiration catheter increases the risk of distal embolization.
- Even with protection, procedural technique is critical to prevent embolic events.
