Bent stents: A method to facilitate delivery of the Palmaz-Schatz stent in tortuous and rigid coronary arteries

Successful stent delivery with deep seating of 6 French guiding catheters in difficult coronary anatomy

“…They include selection of guiding catheters with appropriate configurations providing strong backup support [8,9]; use of extrasupportive wires or a second 0.018Љ stiff wire to straighten the vessel [10]; bending the stent into a gentle curve to steer it around vessel angulations or away from intraluminal irregularities [11]; forming a small bubble at the tip of the stent delivery system to reduce the friction against the artery wall [12]. Deep seating of 6 Fr guiding catheters within the target vessel is another technique for delivering stents beyond tortuous proximal vessels.…”

Push‐pull angioplasty: ACE balloon‐facilitated stent passage technique

“…Unsuccessful stent delivery to the target lesion is a common cause of procedural failure [1]. Several techniques such as the Bubble Stent [2], Buddy Wire [3] techniques, or bending stents on their delivery balloons [4] have been reported. This push-pull ACE technique enhances passage of rigid systems through noncompliant vessels.…”

Novel technique for stent delivery in tortuous coronary arteries: Report of three cases

“…Sometimes it is confounded by sharp angles created by bypass vein hook-ups. When conven- More support Smaller-caliber guide [3] Deep engagement Guidewire Ironman/PlatinumPlus or 0.018Љ wire More support Less support wire More flexible Bent wire [4] Obviates local wire bias Superstiff buddy wire [5] Straightens tortuosity Stent Bent stent [6,7] Aligns stent with tortuosity Inflate tip of balloon slightly, Bubble Stent [8] Improves Push-pull angioplasty with ACE balloon [9] Better fixed support; straightens tortuosity Proximal stenting [10] Alters approach anatomy Constant forward pressure with deep breath Reduces tortuosity Our technique Forward pressure with partial stent balloon inflation tional techniques of complex stent delivery fail, it is useful to have additional "bag of tricks" to convert a disappointing failure into a pleasing success. The technique of partial balloon inflation, while applying gentle forward pressure on the stent delivery system, achieves that by straightening the obstructing segment enough to allow stent passage to the distal target.…”

“…Quite often, however, the predilatation results are inadequate or there is a significant dissection or haziness that mandates a stent. Many techniques of stent delivery have been described for these difficult situations [3][4][5][6][7][8][9][10][11][12][13]. Still, seemingly impossible stent passage is occasionally encountered.…”