Efficacy and safety of balloon-assisted microdissection with Sapphire® II 1.0-mm balloon in balloon-uncrossable chronic total occlusion lesions

Abstract

Objective Earlier studies have shown that the balloon-assisted microdissection (BAM) technique is feasible using a 1.2- to 1.5-mm small balloon in balloon-uncrossable chronic total occlusion (CTO) lesions. This study was performed to assess the efficacy and safety of the BAM technique with a Sapphire® II 1.0-mm balloon. Methods In this retrospective study, patients undergoing percutaneous coronary intervention for CTO were consecutively screened for balloon-uncrossable CTO lesions using BAM with the Sapphire® II 1.0-mm balloon. The patients’ clinical and angiographic characteristics and procedural outcomes were collected for analyses. Results Twenty-four balloon-uncrossable CTO lesions were identified. Most of the CTO lesions were located in the right coronary artery, followed by the left anterior descending artery and left circumflex artery. The mean Japanese Multicenter CTO Registry (J-CTO) and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) scores were 1.96 and 1.38, respectively. The total technical success rates were 91.6% (22/24) and 75.00% (18/24) for the lesions that were successfully treated with BAM. No patients developed major complications with the exception of one patient who developed a femoral hematoma. Conclusion BAM with the Sapphire® II 1.0-mm balloon may be an effective and safe technique for balloon-uncrossable CTO lesions.

Angiographic Features and Clinical Outcomes of Balloon Uncrossable Lesions during Chronic Total Occlusion Percutaneous Coronary Intervention

“…In a retrospective study by Ye et al, the efficacy and safety of the BAM technique were assessed in 24 balloon uncrossable CTOs with the Sapphire ® II 1.0 mm balloon (OrbusNeich, Hong Kong, China). The technical success rate was 75% (18/24) for the lesions successfully treated with BAM, with a total technical success rate of 92% (22/24; when BAM failed, 2 patients were successfully treated with laser and 2 with rotational atherectomy) [ 30 ].…”

Compressive Coronary Intramural Hematoma: A Case Report

“…In our case, we assumed that the complication was due to the grenadoplasty technique. This technique, also known as balloon-assisted microdissection, is a relatively safe plaque modification method for balloon uncrossable lesions by intentional balloon rupture [ 4 ]. However, the complications were detected early; hence, preventive measures for worsening conditions were performed.…”