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A 4-F coaxial catheter system for pediatric vascular occlusion with detachable balloons
P E Burrows1, P LasJaunias, K G TerBrugge
1Department of Radiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Detachable latex balloons in angiographic catheters show promise for pediatric arterial interventions. Successful placement was achieved in six of eight young patients, with no arterial occlusions reported.
Area of Science:
- Interventional Radiology
- Pediatric Cardiology
Background:
- Angiographic catheters are crucial for vascular imaging and interventions.
- Pediatric patients present unique challenges for arterial access and manipulation.
Purpose of the Study:
- To evaluate the feasibility and safety of using detachable latex balloons preloaded in 4-F angiographic catheters for pediatric arterial procedures.
- To assess the success rate of balloon placement in pediatric patients.
Main Methods:
- Eight pediatric patients (aged 6 weeks to 12 years) underwent procedures using detachable latex balloons within 4-F angiographic catheters.
- Balloon placement success was assessed, and complications such as arterial occlusion were monitored.
Main Results:
- Successful balloon placement was achieved in six out of eight patients, particularly when feeding arteries had an oblique origin.
- No instances of femoral or axillary arterial occlusion were observed.
- The balloon system demonstrated expandability up to 8 mm and retrievability through a 4-F sheath.
Conclusions:
- Detachable latex balloons preloaded in angiographic catheters are a potentially viable tool for select pediatric arterial interventions.
- While effective in some cases, challenges include balloon preparation, required operator experience, and navigation difficulties.
Abstract:
Detachable latex balloons, preloaded coaxially in 4-F angiographic catheters, were used in eight patients, aged 6 weeks to 12 years. Successful placement of the balloon was achieved in six patients, in whom the feeding arteries arose in an oblique fashion from the aorta or main conducting arteries. Placement was not possible in two patients. No femoral or axillary arterial occlusions occurred as a result of these procedures. The balloon can be inflated up to 8 mm in diameter, passes readily through a 4-F introducer sheath, and can be retrieved, without detachment from the catheter, through the same sheath. A hemostatic side-arm adapter attached to the catheter permits angiography to be performed before balloon detachment. The disadvantages of the system include preparation time to hand tie the balloons, the operator experience required, and difficulty in navigating the balloon.