Intraaortic balloon pump insertion is traditionally performed through the femoral artery in the groin. However, this restricts the patient to bed rest, and prolonged implantation can be associated with infections in the groin crease. We describe a technique of insertion of a balloon pump through the subclavian artery, which allows ...

A child had a percutaneous endoscopic gastrostomy tube removed by transecting it at skin level. The internal portion ("the bolster") was allowed to pass in the GI tract. She subsequently had odynophagia. Magnetic resonance imaging identified a foreign body within the lower thoracic esophagus. During esophagoscopy, the bolster was removed. ...

BACKGROUND: Balloon pulmonary valvuloplasty and its benefit on the growth of pulmonary annulus and pulmonary artery in tetralogy of Fallot (TOF) patients remains controversial. The purpose ofthe present study was to determine the growth of pulmonary valve annulus and pulmonary artery and to evaluate the need of transannular patch during ...

Severe calcification of the ascending aorta and the aortic arch complicates cardiac surgery. The optimal approach in such patients is unknown. Four valve surgeries were performed with balloon occlusion without hypothermic circulatory arrest. All patients had femoral arterial cannulation, and all 3 patients who required an aortotomy had right axillary ...

Acute iatrogenic arterial dissection is a known complication of endovascular techniques and can be treated with prolonged ballooning, stent placement, or balloon fenestration. Treatment of common femoral artery (CFA) dissection needs special attention because of the potential compromise of either the deep or superficial femoral artery origin and the enhanced ...

Three-dimensional computed tomography (3D-CT) not only allows accurate preoperative delineation of the lesions but also provides precise pathomechanic diagnosis for planning the most effective treatment to avoid respiratory compromise. In a 10-month-old baby girl, who was ventilator-dependent after successful correction of double outlet right ventricle (DORV), flexible fiberoptic bronchoscopy (FFB) ...

The AngioSculpt scoring balloon catheter (AngioScore, Inc., Fremont, California) has recently been developed for percutaneous intervention in coronary and peripheral arteries. This device is composed of two major components, a minimally compliant balloon and three nitinol wore. The three wires encapsulate the low-compliant balloon in a spiral configuration. The concept ...

AIMS: Transcatheter aortic valve implantation (TAVI) is becoming a safe and effective technique for treating symptomatic aortic valvular stenosis (AVS) as an alternative to surgery in very high-risk patients. A possible consequence of valve implantation is the obstruction of coronary ostia. METHODS AND RESULTS: Here we report five cases of ...

In patients with hypoplastic left heart syndrome who experience the Norwood surgical palliative program, development of the pulmonary artery branches is crucial. Balloon dilation and stenting may relieve potential stenosis but complete occlusion remains difficult to address with transcatheter therapy. We report the use of radiofrequency followed by balloon dilation ...

OBJECTIVES: To determine the safety and immediate efficacy after balloon aortic valvuloplasty (BAV) with a new, low-profile balloon. BACKGROUND: BAV has a continuing role in the management of high-risk patients with severe aortic stenosis (AS). BAV with traditional noncompliant balloons requires a large femoral arteriotomy and is associated with high ...

OBJECTIVE: The purpose of this study was to describe a blinded intra-aortic balloon occlusion (IABO) procedure in pelvic fractures (PF) for patients with critically uncontrollable hemorrhagic shock (CUHS). METHODS: Of 2,064 patients treated for PF, 13 underwent IABO during initial resuscitation to control massive pelvic bleeding leading to CUHS. Our ...

Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and ...

A 7-year-old girl with Williams-Beuren syndrome had undergone multiple percutaneous interventions for resistant peripheral pulmonary arterial stenoses with primarily conventional high-pressure balloon dilatation, but also with use of a cutting balloon. On this occasion, we used the AngioSculpt (AngioScore, Alameda, California) to remodel her distal vessels bilaterally with good effect. ...

A 77-year-old man with dilated cardiomyopathy, atrial fibrillation, QRS duration of 140 ms, and NYHA functional class III was referred for cardiac resynchronization therapy device implantation. Coronary sinus (CS) contrast venography by balloon catheter showed no evidence of tributary veins, mimicking total occlusion of the CS. It was found to ...

Transcatheter balloon pulmonary valvuloplasty (BPV) is considered to be the treatment of choice for neonates with critical pulmonary valvar stenosis (PVS) or pulmonary valvar atresia with intact ventricular septum accompanied by reasonable right ventricular volume. The percutaneous femoral venous access is the most preferred route for BPV in most cardiac ...

BACKGROUND: English Bulldogs (EB) with pulmonic stenosis (PS) sometimes have an aberrant coronary artery (CA) type R2A encircling the pulmonary artery (PA). Balloon valvuloplasty (BV) is treatment of choice for severe PS, but is considered to be contraindicated in dogs with aberrant CA. HYPOTHESIS: Conservative BV in EB with aberrant ...

A middle-aged woman presented with massive upper gastrointestinal bleed. The source of bleeding was a large fundic varix; a large splenorenal shunt was also present. The fundic varix was treated safely and effectively with balloon retrograde transvenous occlusion.

We occasionally encountered difficult cases of balloon and stent delivery to the distal lesion because of narrow stent strut, severe calcification, or tortuosity of the proximal section. We describe a new technique to deliver balloon, stent, and guiding catheter to the distal lesion using a distal balloon deflation. This technique ...

OBJECTIVE: This study evaluated the efficiency and feasibility of dilatable bands in selected patients. METHODS: Two types of dilatable handmade bands were retrospectively evaluated and divided into two groups: main pulmonary artery bands and bilateral branch pulmonary artery bands (hybrid stage I palliation). Stepwise balloon angioplasty (BA) was performed, increasing ...

We report a patient with traumatic carotid-cavernous fistula associated with an isolated internal carotid artery in whom, after trans-arterial balloon embolisation, premature balloon detachment occurred with balloon migration to the supraclinoid carotid artery, leading to total occlusion of the blood flow. The carotid flow was eventually restored by direct puncture ...

BACKGROUND: Catheter ablation of the left atrium (LA) is associated with potential collateral injury to surrounding structures, especially the esophagus and the right phrenic nerve (PN). OBJECTIVES: The purpose of this study was to evaluate the efficacy and feasibility of intrapericardial balloon placement (IPBP) for the protection of collateral structures ...

BACKGROUND: Previous studies have shown that stenosis of the arterial anastomosis of thrombosed hemodialysis (HD) grafts, unmasked after conventional thrombectomy, very often necessitate subsequent arterial angioplasty. The aim of this study was to describe a novel fluoroscopic-assisted balloon thrombectomy technique which permits simultaneous arterial angioplasty (should this is required) for ...

The present report describes the case of a 77-year-old man with unstable angina, in which the culprit vessel was extremely angulated and precluded placement of a guidewire for subsequent coronary interventions. A novel technique is reported, using an undersized, uninflated and distally placed balloon catheter, which easily facilitated guidewire placement.

The patient was a 37-year-old female who had undergone a repair for tetralogy of Fallot (TOF) at the age of 4 years. Postoperative pulmonary stenosis remained, but she continued to be managed medically. Approximately 3 years ago, at the age of 34, she exhibited a worsening of fatigue and dyspnea ...

Arterial perforation is a well-recognized complication of attempted percutaneous revascularization of a chronic totally occluded tibial artery and typically necessitates termination of the procedure. This report describes a step-by-step approach on how to perform a direct posterior tibial artery puncture and a sheathless wire introduction, to salvage a case of ...

ABSTRACT Cardiac emboli are a feared complication for patients with left ventricular assist devices (LVAD). Septic emboli are rare but carry a poor prognosis in the setting of large artery occlusion. We report the case of a 24-year-old woman who presents with a left internal carotid artery terminus occlusion secondary ...

Ureteral stenting is a routine, minimally invasive procedure performed for relief of benign or malignant obstruction. In case of ureteral stenosis, to allow a correct insertion of the stent, a predilatation of the ureter stenosis with a conventional balloon catheter can be necessary. In exceptional cases, it can be difficult ...

Balloon valvuloplasty became the treatment of choice for valvular pulmonary stenosis following its first description in 1982 by Kan et al, and has almost replaced surgical pulmonary valvotomy in the present day. It is a safe and effective method for children for relief of right ventricular obstruction. The results of ...

AIM: To retrospectively evaluate the management and outcome of venous obstruction after living donor liver transplantation (LDLT). METHODS: From February 1999 to May 2009, 1 intraoperative hepatic vein (HV) tension induced HV obstruction and 5 postoperative HV anastomotic stenosis occurred in 6 adult male LDLT recipients. Postoperative portal vein (PV) ...

We describe two cases of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery in which we were initially unable to achieve wire crossing. A novel technique of pushing both antegrade and retrograde balloons into the CTO lesion so that the balloons overlapped each ...

INTRODUCTION: Cryothermal, HIFU, and laser catheter-based balloon technologies have been developed to simplify ablation for AF. Initial enthusiasm for their widespread use has been dampened by phrenic nerve (PN) injury. The interaction between PN and pulmonary vein (PV) geometry contributing to PN injury is unclear. METHODS AND RESULTS: After right ...

Extensive damage of viable myocardium usually causes cardiogenic stock. A case of cardiogenic shock successfully treated by rescue PTCA without a balloon pumpin a non-diabetic, normotensive, 50 years old male patient is reported here.

Plasma levels of brain natriuretic peptide (BNP) have been shown to correlate to aortic stenosis severity and are predictive of symptom development and survival. They also predict postoperative outcomes after valve replacement in patients with aortic stenosis. The early evolution of N-terminal-pro-BNP (NT-pro-BNP) levels after 50 aortic balloon valvuloplasty procedures ...

To evaluate the appropriateness of commercial guideline in selecting the size of balloon for intraaortic counterpulsation in Asian patients, we analyzed the relationship between aortic dimensions measured from computed tomography and body indexes. There were 125 patients who underwent the computed tomography. They were divided into three height groups [<152 ...

There is little information about the relationship between balloon inflation time and sirolimus-eluting stent (SES) expansion. In this randomized intravascular ultrasound (IVUS) study, 92 de novo lesions in native coronary arteries that underwent SES implantation were enrolled. Sirolimus-eluting stent was implanted using an inflation pressure of 14 atm. Stent balloon ...

Treatment with percutaneous extracorporeal mechanical assist devices provides the ultimate therapeutic option to improve the macrocirculation in patients suffering from refractory cardiac arrest, severe cardiogenic shock or during high-risk interventions. However, the flow in the smallest vessels in these critical periods is poorly understood but prognostically of high importance. Using ...

Percutaneous coronary intervention (PCI) using retrograde approach through venous grafts or collateral vessels is a promising option for chronic total occlusion (CTO) lesions in which antegrade crossing is not possible. We describe a successful retrograde balloon dilatation of right coronary artery lesions through a venous graft in a patient with ...

Real time two-dimensional transthoracic and transesophageal echocardiography demonstrated a mobile echolucent mass attached to the pulmonary valve in a 25-year-old adult, 20 years following balloon pulmonary valvuloplasty. The mass was surgically excised and pathology showed it to be a cyst.

AIM: Almost all cross-clamps utilized in vascular surgery, even atraumatic clamps, have been shown to cause mechanical damage to the vascular wall. In recent years, surgical procedures using an endoluminal balloon technique have been reported as an alternative occlusion strategy. This study discusses the histopathological characteristics and comparison between vascular ...

Summary: No balloon microcatheter with a 3 cm marker has been developed to date.We developed a new balloon microcatheter with a double marker. This balloon microcatheter, with an outer diameter of 2.8 F, has a balloon on the most distal portion with a maximum inflation diameter of 4 mm and ...

The T technique is not uncommonly used to stent bifurcation lesions. It requires recrossing into the side branch with a guidewire and balloon to perform final Kissing Balloon dilations, but recrossing can be difficult. We describe a case of bifurcation stenting where balloon recrossing following guidewire placement into the side ...

The treatment of acute limb ischemia is always challenging. Various techniques including balloon angioplasty, rheolytic thrombectomy, and prolonged localized infusion of thrombolytics are often used to achieve revascularization. However, some patients with suboptimal angiographic results may benefit from novel alternatives such as the Clearway irrigation balloon (Atrium, Hudson, NH, USA). ...

Snaring the retrograde wire in the aortic root was successfully performed for treatment of a chronic total occlusion (CTO) lesion of a saphenous vein graft interposed between a prosthetic graft and the right coronary artery (RCA) ostium in a patient with Behcet's disease after two Bentall operations. Although the coronary ...

Despite increasing corrective procedures for children with congenital heart disease, there remains a place for surgical banding of the main pulmonary artery (PA). In the vast majority of cases, these bands eventually need to be removed. We examined three cases of percutaneous disruption of PA bands using balloon catheters at ...

Failure of the balloon to pass through for a side branch in spite of wire crossing occasionally occurs due to a jailed stent during treatment of bifurcation lesions. In this report, we describe a novel 0.010-inch coronary guidewire compatible balloon (IKAZUCHI 10 ) that is effective for crossing a side ...

The intra-aortic balloon pump (IABP) is a mechanical circulatory assist device commonly used for patients with cardiogenic shock or perioperative cardiac failure. The use of IABPs is, however, associated with severe complications occurring in 6-15% of patients. We report a case and present images of a patient who died of ...

BACKGROUND: Restenosis occurs invariably within 1 year following balloon valvulopasty in aortic valve stenosis. The mechanism of restenosis seems to involve a dynamic cellular component that could be a target for drug inhibition. We investigated the feasibility of local drug delivery at the aortic valve tissues of healthy pigs with ...

OBJECTIVES: To report our experience with balloon dilation of critical aortic valvar stenosis in neonates via the umbilical artery using currently available catheters. BACKGROUND: There is no agreement regarding the optimal vascular approach for balloon dilation of critical aortic valvar stenosis in neonates. METHODS: Since June of 2005, we have ...

A newborn presented with severe aortic valve stenosis and a borderline hypoplastic left ventricle due to disproportionate left ventricular hypertrophy (maternal diabetes). The aortic valve was balloon dilated and the infant tolerated a biventricular circulation. However, severe retrograde pulmonary hypertension and mitral regurgitation developed, indicating that biventricular circulation was not ...

A retrograde approach through the collateral channels is considered to improve the success rate of percutaneous coronary intervention for coronary chronic total occlusion (CTO). Various kinds of strategies and techniques are required to improve the success rate of this novel approach. We describe a case in which a CTO was ...