Reinforcement of the anchor balloon system in percutaneous coronary intervention: an in vitro assessment

We evaluated the factors that increase the maximum static friction force between the anchoring balloon and the vessel wall. The anchor technique in percutaneous coronary intervention (PCI) may be better supported by a guiding catheter. However, in some cases, the anchor balloon does not perform optimally due to slippage within the anchoring vessel. Furthermore, the optimal procedure for balloon anchoring remains unknown. We evaluated the maximum static friction force of the anchor balloon via in vitro assessments using a simulated vessel model and coronary balloons. The simulated vessel model was composed of polytetrafluoroethylene, and its inner diameter was 1.5 mm. The various-sized balloons (diameter: 1.5 mm, 1.75 mm, and 2.0 mm; length: 10 mm and 15 mm) were inflated within the simulated vessel at various atmospheres. The maximum static friction force was measured by pulling on the balloon catheter shaft using 10-g weights. We performed the same experiment with a jailing 0.014″ wire under the anchoring balloon. Evaluated wires included a silicon coating coil wire, hydrophilic coating coil wire, polymer-coated non-tapering wire, and polymer-coated tapered wire. The maximum static friction force between the anchoring balloon and the simulated vessel increased with an increase in inflation pressure and balloon length. However, increasing the balloon diameter was not effective. The jailing 0.014″ wire, particularly coil wire, was effective in increasing the maximum static friction force of the anchor balloon. A longer balloon, higher inflation pressure, and jailing coil wire could reinforce the anchor balloon system.