No abstract

A new technique employing two balloon probes via a single (large-lumen) guiding catheter is described. Examples involving the left anterior descending, diagonal, left main (protected), left circumflex-obtuse marginal, and atrioventricular branches and the right coronary artery-posterior descending and posterolateral branches are described and illustrated. This new technology (balloon probes and large-lumen guiding catheter) permits an effective and simplified alternative to the use of the single-guide/two-wire and double-guide/two-dilatation catheter-wire approaches in selected cases in which significant branch vessels (vis-a-vis myocardial regional blood supply) are at risk.

No abstract

To evaluate trends in morphology-based intervention selection, series of 110 consecutive procedures of each of three devices, percutaneous transluminal balloon coronary angioplasty (PTCA), directional coronary atherectomy (DCA), or high-speed rotational ablation (HSRA), were reviewed. PTCA was used mainly in discrete, concentric, smooth, ACC/AHA type A and B1 lesions. PTCA was used less frequently on a bend, branching points or in calcified lesions. Using PTCA as a reference, DCA was used more often for the treatment of discrete, proximal, eccentric, and noncalcified lesions, often complicated with thrombus and located on straight segments. HSRA was used more frequently in diffuse, calcified multiple complicated and B2+C type lesions with frequent side branches and bend points. These results suggest that directional atherectomy and rotational ablation may be helpful in expanding the capacity of the operator to approach prognostically unfavorable lesions.