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A novel side branch protection technique in coronary stent implantation: Jailed Corsair technique
Yohei Numasawa1, Kenichi Sakakura2, Kei Yamamoto2
1Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan.
Insights
Side branch occlusion during percutaneous coronary interventions (PCI) is a risk. A novel "Jailed Corsair technique" using a microcatheter effectively protected a side branch, preventing occlusion.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Side branch occlusion is a frequent complication during percutaneous coronary interventions (PCI), linked to adverse cardiac events.
- Preserving side branch blood flow during PCI of coronary artery bifurcation lesions is clinically important.
Observation:
- A 72-year-old male presented with angina pectoris and diffuse calcified stenosis in the left anterior descending coronary artery with a large diagonal branch.
- The conventional jailed wire technique failed to prevent side branch occlusion in previous cases.
Findings:
- A novel "Jailed Corsair technique" utilizing a Corsair microcatheter was successfully employed to protect the side branch.
- This technique demonstrated an advantage over the jailed balloon technique for side branch protection.
Implications:
- The Jailed Corsair technique offers a promising alternative for preventing side branch occlusion during complex PCI.
- This approach may improve outcomes for patients undergoing intervention for bifurcation lesions.
Abstract:
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel. However, the jailed wire technique could not always prevent side branch occlusion. In this case report, we described a case of 72-year-old male suffering from angina pectoris. Coronary angiography revealed the diffuse calcified stenosis in the proximal and middle of left anterior descending coronary artery, and the large diagonal branch originated from the middle of the stenosis. To prevent side branch occlusion, we performed a novel side branch protection technique by using the Corsair microcatheter (Asahi Intecc, Nagoya, Japan). In this case report, we illustrated this "Jailed Corsair technique", and discussed the advantage compared to other side branch protection techniques such as the jailed balloon technique.
