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Clinical experience with the use of the angled-balloon dilatation catheter
V Vivekaphirat1, C Zapala, A E Foschi
1Department of Medicine, Saint Francis Hospital, Evanston, IL 60202.
Insights
A novel angled-balloon catheter improves outcomes for coronary angioplasty (PTCA) in challenging anatomies. This specialized device successfully treated stenoses at arterial angles and bifurcations with reduced complications.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Coronary artery stenosis often occurs at complex angles or bifurcations.
- Traditional balloon catheters may lead to complications in these anatomies.
Purpose of the Study:
- To evaluate the efficacy and safety of a newly developed angled-balloon catheter for percutaneous transluminal coronary angioplasty (PTCA).
- To assess the catheter's performance in treating stenoses located at angled portions and bifurcations of coronary arteries.
Main Methods:
- A prospective study involving 39 patients (29 men, 10 women) undergoing PTCA.
- The angled-balloon catheter was used in 43 stenotic sites, with a focus on angled portions (32 sites) and side branches of bifurcations (11 sites).
- Angiographic assessment and clinical follow-up were performed.
Main Results:
- Successful angioplasty was achieved in 41 out of 43 stenotic sites (95.4%).
- No instances of intimal tear or dissection were observed.
- Acute closure did not occur.
- Restenosis was observed in 6 patients (15.4%) at a mean follow-up of 239.5 days.
Conclusions:
- The angled-balloon dilatation catheter demonstrates significant potential for reducing intimal trauma and dissection during PTCA.
- It is particularly beneficial for treating stenoses in angled coronary segments and at the origin of side branches in bifurcations.
- This specialized catheter offers an improved approach for specific complex coronary anatomies.
Abstract:
A special balloon catheter has been developed for use in coronary angioplasty. The balloon portion has a 135 degrees - 145 degrees angle at its mid portion. It is designed for stenosis located at an angle of the coronary artery. We investigated the use of this catheter in 39 patients who underwent percutaneous transluminal coronary angioplasty (PTCA): 29 men and 10 women. PTCA was attempted in 43 stenotic sites. Thirty-two stenoses were located at the angled portion of the dilated arteries. Eleven stenoses were located at the side branches of the acutely angled bifurcations. Twenty stenoses were in the right coronary artery distribution. Twenty-two stenoses were in the left coronary artery distribution. One stenosis was at the origin of the left internal mammary artery. Forty-one stenoses were angioplastied successfully (95.4%). No angiographic evidence of intimal tear or dissection was noted in all of the dilated vessels. Acute closure was not observed. The mean follow-up period was 239.5 days. Six patients (15.4%) were found to have restenosis. We conclude that the use of the angled-balloon dilatation catheter provides the potential benefit of reducing intimal trauma and dissection during PTCA of certain coronary anatomies--stenosis at the angled portion or at the takeoff of the side branch of a bifurcation.