Balloon catheter systems for PTCA: the importance of the catheter length

The length of a balloon catheter system plays an important role in successfully dilating distal coronary or vein graft stenoses. We herein report a case in which a distal saphenous vein graft lesion could not be reached with a conventional balloon catheter. Factors responsible for this failure included insufficient length. The lesion was eventually reached and successfully dilated with another balloon catheter, which according to the manufacturer had the same length as the first balloon. In order to study this phenomenon eleven balloon catheters were examined using the following measurements: functional catheter length, deliverable catheter length, crossing distance and longitudinal compression. Seven guide catheters were also measured. Results showed variations in standard functional length between several manufacturers, ranging from 132.2-137.8 cm. The deliverable length ranged from 18.3-23.9 cm, crossing distance ranged from 7-37 mm, and the longitudinal compression ranged from 4-30 mm. Guiding catheter length varied among several manufacturers, ranging from 100.6-107 cm. A significant variation was found not only among certain manufacturers, but also among several standard catheters made by one manufacturer. The results of this study suggest that significant variations exist in the length of standard balloon catheters and guiding catheters even among those made by the same manufacturer. These findings can affect the ability to reach a lesion and should be taken into account, especially when attempting to perform angioplasty of stenoses located in the distal portion of a coronary artery or saphenous vein graft.