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

Abstract

Improvements in interventional cardiology equipment have facilitated the treatment of more complex anatomies. Bulky stent transport systems and the inflexibility of stents have remained a limitation to the delivery of stents to distal, angulated, stiff, and calcified vessels. In order to provide the strongest guide backup, some vessel straightening, and a stiff rail over which the stent apparatus could be passed, an ACE balloon was advanced past the target lesion and used to trap the distal wire by gently inflating the ACE balloon at low pressure. Traction is then placed on the ACE catheter and the angioplasty guide wire at the touey valve insertion site. This procedure facilitates easy passage of angioplasty devices through challenging anatomies. In addition to the two case reports described, this technique has been used numerous other times with consistent success. Cathet. Cardiovasc. Intervent. 48:93–95, 1999. © 1999 Wiley‐Liss, Inc.