The Small Balloon Bridge: an Improved Technique for Re-accessing Carotid Artery Stent.

BACKGROUND: There is a new research reported that the technology for navigating the catheter, which is eccentric or tangentially angled to the long axis of a CAS（Carotid Artery Stent）. In the clinical practices, we found that there is still existed resistance when the 8F guiding catheter crossing the balloon, even if it is partially expanded. Therefore, we intended to improve the operating procedure by utilizing a smaller balloon with a diameter of 2 mm. The smaller balloon can navigate the guiding catheter re-access the angled junction with minimal resistance after it is fully expanded.

CASE DESCRIPTION: We applied the small balloon bridge technology in one case of left internal carotid artery stent implantation. After the stents were released successfully, we found that it was difficult to recapture umbrella, because the guiding catheter had a steep angle to the long axis of carotid artery with released stents. To overcome this obstacle, we sent a 2mm balloon into the tip of the catheter, then inflated it fully. Therefore, the steep angle could be straightened due to the expanded balloon played a supportive effect. As a result, the guiding catheter re-accessed the previous angled junction smoothly as the small balloon moving forward, and recaptured the umbrella successfully.

CONCLUSIONS: Using the small balloon bridge technique to navigate the guiding catheter is a safer, simpler and more effective operation for carotid interventional therapy. Furthermore, it might be also applied to other endovascular treatments that require the guiding catheters for intervention.