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

Abstract

We present a novel technique for stent delivery across tortuous lesions. Gentle forward pressure was applied on the stent balloon while the balloon was inflated to 2-3 atm. This resulted in the balloon and stent crossing the impeding segment and settling in the target site where it was deployed with excellent angiographic outcome.

The importance of vessel factors for stent deployment in diseased arteries

“…Fernandes et al [27] reported three cases of stent angioplasty on angulated lesions, and found that arterial bends or sharp vessel angulation can obstruct the passage of the stent. Myouchin et al [28] studied 31 cases of stent deployment close to inflection points of the artery, of which 2 had unsuccessful treatment of the lesion.…”

Distal balloon deflation technique: A new method to facilitate entry of balloon catheter, stent, and guiding catheter to distal lesion

“…A previous report showed that nearly 5% of lesions could not be successfully treated with dug‐eluting stents [6]. For cases involving severe calcification or tortuosity of the proximal section that hinders stent delivery, methods such as using a wire with high backup force that extends the vessel, inner catheter, anchor techniques, and aspiration catheter were attempted in many cases [7–10]. Buddy and extra support wire, inner catheter, and anchor technique enable the stent delivery to provide not only the guiding catheter with coaxial positioning but also higher backup support.…”

Performance of the XLIMUS Sirolimus‐Eluting Coronary Stent in Very Complex Lesions

“…The deliverability of a coronary stent is usually assessed by how easy it is to navigate through tortuous/calcified vasculature to the target lesion and cross the lesion. Optimal support by guiding catheters, adequate lesion preparation, and use of buddy wires/stiffer wires has been suggested to facilitate stent delivery in these complex lesion subsets . The GuideLiner catheter (Vascular Solutions, Inc., Minneapolis, MN, USA) is also a useful adjunctive tool to facilitate stent delivery across heavily calcified lesions and/or tortuous vessels .…”