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Feasibility of kissing balloon technique through guide extension catheters: an experimental bench test

  • Takayuki WarisawaEmail author
  • Shingo Kuwata
  • Mizuho Kasahara
  • Shunichi Doi
  • Yui Nakayama
  • Norio Suzuki
  • Manabu Takai
  • Hisao Matsuda
  • Koichi Mizuno
  • Yoshihiro J. Akashi
Original Article
  • 24 Downloads

Abstract

Previous reports showed that GuideLiner (GL) and Guidezilla (GZ) can accommodate bulky and multiple devices beyond the official profiles. However, feasibility of kissing balloon technique (KBT) through these devices is unknown. The tested devices included 7Fr-GL/GZ and respective three types of 2.5 mm semi-compliant (SC) and non-compliant (NC) balloons: conventional model (CM), tapered-tip model (TM) and latest model (LM). First, three experienced operators attempted to advance all 21 combinations of the 2 balloons through GL/GZ on the guidewires and assessed the crossability in 3 grades: easy, difficult and impossible. Second, the only balloon combinations graded as easy by all operators were tested in the polyurethane-made bifurcation model which required KBT following cross-over stenting. Within the total of 42 device combinations, only one balloon combination of double LM–NC balloons was classified as easy in both GL/GZ by consensus opinion of the operators. While two combinations of LM–SC and LM–SC/NC balloons were classified as difficult in both GL/GZ, all four combinations of LM–SC/NC and CM/TM–NC balloons were classified as difficult only in GL. Other 32 combinations were all classified as impossible. In the bifurcation model, the combination of double LM–NC balloons using GL achieved KBT while the same balloon combination with GZ failed. The feasibility of KBT using child-catheter is highly dependent on the device characteristics. The combination of latest small-profile NC balloons through GL could be clinically applicable.

Keywords

Child-catheter Guide extension catheter GuideLiner Guidezilla Kissing balloon inflation 

Notes

Compliance with ethical standards

Conflict of interest

TW reports consultancies work for Abbott Vascular and Philips. All other authors report no conflicts of interest.

Supplementary material

12928_2019_622_MOESM1_ESM.docx (42 kb)
Supplementary material 1 (DOCX 42 kb)

Supplementary material 2 (MP4 805 kb)

Supplementary material 3 (MP4 886 kb)

Supplementary material 4 (MP4 789 kb)

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2019

Authors and Affiliations

  • Takayuki Warisawa
    • 1
    • 2
    Email author
  • Shingo Kuwata
    • 2
  • Mizuho Kasahara
    • 3
  • Shunichi Doi
    • 2
  • Yui Nakayama
    • 3
  • Norio Suzuki
    • 3
  • Manabu Takai
    • 3
  • Hisao Matsuda
    • 3
  • Koichi Mizuno
    • 3
  • Yoshihiro J. Akashi
    • 2
  1. 1.NHLI-Cardiovascular Science, Imperial College LondonHammersmith HospitalLondonUK
  2. 2.Division of Cardiology, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
  3. 3.Department of CardiologySt. Marianna University School of Medicine Yokohama City Seibu HospitalYokohamaJapan

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