Multivessel ptca using the hugging balloon technique based on single guide catheter and dual balloon‐on‐a‐wire systems

Abstract

For percutaneous transluminal coronary angioplasty (PTCA) of oversized arteries, often-times a satisfactory dilatation cannot be achieved with conventional balloon systems due to the unavailability of adequately sized balloons. This fact has contributed to a higher restenosis rate for this group of patients. We were able to obtain a satisfactory dilatation result in an oversized right coronary artery with a shepherd's crook configuration and eccentric anatomy at the origin using two balloon-on-a-wire systems and an Amplatz type guiding catheter. Although such favorable dilatation of an oversized artery using this "hugging balloon technique" can be expected, issues do exist such as difficult maneuverability and estimation of the balloon size obtained through simultaneous dual balloon inflation wherein size does not simply equal the sum of the two balloon catheters. It is hoped that there will be further improvements of the technique and development of new systems. At this time, however, it is felt that this is the most effective and reasonable strategy to achieve a high chance of success in oversized vessel lesions.

Kissing balloon technique in complex ptca: Single guiding catheter and dual wire rapid exchange system

“…Recent publications by Myler et al [2], Leeuwen et al. [3], Yoshida et al [ 5 ] , and Heijer et al [4] have described the "kissing balloon" technique using two balloons through a single guiding catheter for complex bifurcating coronary arterial lesions. These studies describe either a balloon with fixed wire in combination with a balloon over the wire, two balloons with fixed wires or two balloons over long exchange wires.…”