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Symes DG, McNamara LM, Conway C. Computational Investigation of Vessel Injury Due to Catheter Tracking During Transcatheter Aortic Valve Replacement. Ann Biomed Eng 2024; 52:1554-1567. [PMID: 38589731 PMCID: PMC11081929 DOI: 10.1007/s10439-024-03462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/30/2024] [Indexed: 04/10/2024]
Abstract
Catheter reaction forces during transcatheter valve replacement (TAVR) may result in injury to the vessel or plaque rupture, triggering distal embolization or thrombosis. In vitro test methods represent the arterial wall using synthetic proxies to determine catheter reaction forces during tracking, but whether they can account for reaction forces within the compliant aortic wall tissue in vivo is unknown. Moreover, the role of plaque inclusions is not well understood. Computational approaches have predicted the impact of TAVR positioning, migration, and leaflet distortion, but have not yet been applied to investigate aortic wall reaction forces and stresses during catheter tracking. In this study, we investigate the role that catheter design and aorta and plaque mechanical properties have on the risk of plaque rupture during TAVR catheter delivery. We report that, for trackability testing, a rigid test model provides a reasonable estimation of the peak reaction forces experienced during catheter tracking within compliant vessels. We investigated the risk of rupture of both the aortic tissue and calcified plaques. We report that there was no risk of diseased aortic tissue rupture based on an accepted aortic tissue stress threshold (4.2 MPa). However, we report that both the aortic and plaque tissue exceed a rupture stress threshold (300 kPa) with and without the presence of stiff and soft plaque inclusions. We also highlight the potential risks associated with shorter catheter tips during catheter tracking and demonstrate that increasing the contact surface will reduce peak contact pressures experienced in the tissue.
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Affiliation(s)
- David G Symes
- Biomedical Engineering, School of Engineering, College of Science and Engineering, University of Galway, Galway, Ireland
| | - Laoise M McNamara
- Biomedical Engineering, School of Engineering, College of Science and Engineering, University of Galway, Galway, Ireland
| | - Claire Conway
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin & RCSI, Dublin, Ireland.
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2
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Campos JK, Zarrin DA, Meyer BM, Khan MW, Laghari FJ, Collard de Beaufort JC, Amin G, Beaty NB, Bender MT, Suzuki S, Colby GP, Lin LM, Coon AL. Use of a large-bore 088 intracranial access support catheter for delivery of large intracranial devices: case series with the TracStar LDP in 125 cases. J Neurointerv Surg 2024:jnis-2023-021054. [PMID: 38418227 DOI: 10.1136/jnis-2023-021054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND The delivery of neuroendovascular devices requires a robust proximal access platform. This demand has previously been met with a 6Fr long sheath (8Fr guide) that is placed in the proximal internal carotid artery (ICA) or vertebral artery segments. We share our experience with the first 0.088 inch 8Fr guide catheter designed for direct intracranial access. METHODS We retrospectively reviewed a prospectively maintained IRB-approved institutional database of the senior authors to identify all cases where the TracStar Large Distal Platform (LDP) was positioned within the intracranial vasculature, defined as within or distal to the petrous ICA, vertebral artery (V3) segments, or transverse sinus. Technical success was defined as safe placement of the TracStar LDP within or distal to the described distal vessel segments with subsequent complication-free device implantation. RESULTS Over the 41-month study period from January 2020 to June 2023, 125 consecutive cases were identified in whom the TracStar LDP was navigated into the intracranial vasculature for triaxial delivery of large devices, 0.027 inch microcatheter and greater, for aneurysm treatment (n=108, 86%), intracranial angioplasty/stenting (n=15, 12%), and venous sinus stenting (n=2, 1.6%). All cases used a direct select catheter technique for initial guide placement (no exchange). Posterior circulation treatments occurred in 14.4% (n=18) of cases. Technical success was achieved in 100% of cases. No vessel dissections occurred in any cases. CONCLUSION The TracStar LDP is an 0.088 inch 8Fr guide catheter that can establish direct intracranial access with an acceptable safety profile. This can be achieved in a wide range of neurointerventional cases with a high rate of technical success.
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Affiliation(s)
- Jessica K Campos
- Department of Neurosurgery, University of California Irvine, Orange, California, USA
| | - David A Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Benjamen M Meyer
- College of Medicine Tucson, The University of Arizona, Tucson, Arizona, USA
| | - Muhammad Waqas Khan
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Fahad J Laghari
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | | | - Gizal Amin
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Narlin B Beaty
- Department of Neurosurgery Tallahassee Memorial Hospital, Tallahassee Memorial Hospital Florida State University, Tallahassee, Florida, USA
| | - Matthew T Bender
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Shuichi Suzuki
- Department of Neurosurgery, University of California Irvine, Orange, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Li-Mei Lin
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Alexander L Coon
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
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Trackability of a high-strength thromboresistant hydrogel catheter: An In vitro analysis comparing venous catheter forces in a simulated use pathway. J Mech Behav Biomed Mater 2023; 139:105670. [PMID: 36646006 DOI: 10.1016/j.jmbbm.2023.105670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
As the need for vascular access devices (VADs) continues to increase, so does the need for innovative designs and materials that can improve placement and optimize patient outcomes. Commercially available peripherally inserted central venous catheters (PICCs) are in high demand due to their ease of use and low cost. However, they are constructed of materials that can contribute to vascular injury and result in complications such as clotting, catheter failure, and infection. This study investigated the surface and frictional properties of a HydroPICC® device constructed of a novel, inherently lubricious bulk hydrogel. Investigators posited that these materials would lower the forces required to advance and retract the HydroPICC® devices and that the measured forces are significantly lower than those of two commercially available PICCs made of conventional thermoplastic polyurethane. The HydroPICC® device had a lower insertion and retraction force compared to both the PowerPICCTM and BioFloTM control devices based on an unpaired, two-sided t-test (P < .001). The HydroPICC® also exhibited a statistically significant decrease in average force when compared to both conventional PICCs (P < .001 and P = .001). When compared to PowerPICCTM, the lubricious high-strength HydroPICC® hydrogel device exhibited an 84% ± 25% reduction in average tracking force; additionally, when compared to a fluoro-oligomer modified TPU catheter (BioFloTM), the HydroPICC® device exhibited a 90 ± 32% reduction in average tracking force. The HydroPICC® technology represents a new method to reduce frictional forces of implantable devices. Clinical trials are needed to determine whether the differences in frictional properties between conventional VADs and HydroPICC® devices translate into improved clinical outcomes.
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Sirivella ML, Rahinj GB, Chauhan HS, Satyanarayana MV, Ramanan L. Numerical Methodology to Evaluate Trackability and Pushability of PTCA Balloon Catheter. Cardiovasc Eng Technol 2023; 14:315-330. [PMID: 36717510 DOI: 10.1007/s13239-022-00653-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 12/20/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE During percutaneous coronary intervention (PCI), the ability to navigate a catheter without causing injury to the vessel and damage to the device is crucial outcome of the procedure. This study aimed to develop a numerical model to analyse the percutaneous transluminal coronary angioplasty (PTCA) catheter navigation in coronary vessels. METHODS Trackability and pushability are two major parameters used to characterize the navigation of PTCA balloon catheters, and they are influenced by vessel tortuosity, contact interactions and catheter design. In the current study, finite element analysis model is presented to evaluate trackability and pushability considering two different vessel geometries. Impact of contact interactions among catheter, guidewire, and vessel were studied to validate the numerical model with in vitro test data. Further, a parametric study was conducted to understand the influence of distal shaft, and proximal shaft outer diameter. RESULTS Obtained results suggest that contact interaction and co-efficient of friction between guidewire and catheter are critical parameters to obtain numerical results comparable to experimental data. Results from the parametric study predicted strong positive correlation of distal shaft diameter on pushability, and weak correlation on trackability force. Furthermore, parametric variation in proximal shaft diameter has strong positive correlation on trackability force and strong negative correlation on pushability. CONCLUSION Numerical methodology presented in this study is a preliminary attempt to simulate the behavior of PTCA balloon catheter navigation. This methodology will be helpful in the design and optimization of PTCA balloon catheter and similar devices with improved deliverability.
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Affiliation(s)
- Martin L Sirivella
- Research and Development Department, Sahajanand Medical Technologies (SMT) Ltd., Surat, India.
| | - Ganesh B Rahinj
- Research and Development Department, Sahajanand Medical Technologies (SMT) Ltd., Surat, India
| | - Harshit S Chauhan
- Research and Development Department, Sahajanand Medical Technologies (SMT) Ltd., Surat, India
| | - Menta V Satyanarayana
- Research and Development Department, Sahajanand Medical Technologies (SMT) Ltd., Surat, India
| | - Laxminarayanan Ramanan
- Research and Development Department, Sahajanand Medical Technologies (SMT) Ltd., Surat, India
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Li J, Tomasello A, Requena M, Canals P, Tiberi R, Galve I, Engel E, Kallmes DF, Castaño O, Ribo M. Trackability of distal access catheters: an in vitro quantitative evaluation of navigation strategies. J Neurointerv Surg 2022; 15:496-501. [PMID: 35450927 DOI: 10.1136/neurintsurg-2022-018889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND In mechanical thrombectomy (MT), distal access catheters (DACs) are tracked through the vascular anatomy to reach the occlusion site. The inability of DACs to reach the occlusion site has been reported as a predictor of unsuccessful recanalization. This study aims to provide insight into how to navigate devices through the vascular anatomy with minimal track forces, since higher forces may imply more risk of vascular injuries. METHODS We designed an experimental setup to monitor DAC track forces when navigating through an in vitro anatomical model. Experiments were recorded to study mechanical behaviors such as tension buildup against vessel walls, DAC buckling, and abrupt advancements. A multiple regression analysis was performed to predict track forces from the catheters' design specifications. RESULTS DACs were successfully delivered to the target M1 in 60 of 63 in vitro experiments (95.2%). Compared to navigation with unsupported DAC, the concomitant coaxial use of a microcatheter/microguidewire and microcatheter/stent retriever anchoring significantly reduced the track forces by about 63% and 77%, respectively (p<0.01). The presence of the braid pattern in the reinforcement significantly reduced the track forces regardless of the technique used (p<0.05). Combined coil and braid reinforcement configuration, as compared with coil alone, and a thinner distal wall were predictors of lower track force when navigating with unsupported DAC. CONCLUSIONS The use of microcatheter and stent retriever facilitate smooth navigation of DACs through the vascular tortuosity to reach the occlusion site, which in turn improves the reliability of tracking when positioning the DAC closer to the thrombus interface.
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Affiliation(s)
- Jiahui Li
- Stroke Unit, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Alejandro Tomasello
- Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Manuel Requena
- Stroke Unit, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain.,Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Pere Canals
- Stroke Unit, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Riccardo Tiberi
- Stroke Unit, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain.,Materials Science and Engineering, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - Iñaki Galve
- Department of Research and Development, Anaconda Biomed, Barcelona, Spain
| | - Elisabeth Engel
- Materials Science and Engineering, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain.,CIBER en Bioingeniería, Biomateriales y Nanomedicina, CIBER, Madrid, Comunidad de Madrid, Spain
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Oscar Castaño
- Electronics and Biomedical Engineering, University of Barcelona, Barcelona, Catalunya, Spain.,Biomaterials for Regenerative Therapies, Institute for Bioengineering in Catalonia, Barcelona, Catalunya, Spain
| | - Marc Ribo
- Stroke Unit, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain .,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Morris L, Tierney P, Hynes N, Sultan S. An in vitro Assessment of the Haemodynamic Features Occurring Within the True and False Lumens Separated by a Dissection Flap for a Patient-Specific Type B Aortic Dissection. Front Cardiovasc Med 2022; 9:797829. [PMID: 35369331 PMCID: PMC8968342 DOI: 10.3389/fcvm.2022.797829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/15/2022] [Indexed: 11/14/2022] Open
Abstract
One of the highest mortality rates of cardiovascular diseases is aortic dissections with challenging treatment options. Currently, less study has been conducted in developing in vitro patient-specific Type B aortic dissection models, which mimic physiological flow conditions along the true and false lumens separated by a dissection flap with multiple entry and exit tears. A patient-specific Stanford Type B aortic dissection scan was replicated by an in-house manufactured automatic injection moulding system and a novel modelling technique for creating the ascending aorta, aortic arch, and descending aorta incorporating arterial branching, the true/false lumens, and dissection flap with entry and exit intimal tears. The physiological flowrates and pressure values were monitored, which identified jet stream fluid flows entering and exiting the dissection tears. Pressure in the aorta’s true lumen region was controlled at 125/85 mmHg for systolic and diastolic values. Pressure values were obtained in eight sections along the false lumen using a pressure transducer. The true lumen systolic pressure varied from 122 to 128 mmHg along the length. Flow patterns were monitored by ultrasound along 12 sections. Detailed images obtained from the ultrasound transducer probe showed varied flow patterns with one or multiple jet steam vortices along the aorta model. The dissection flap movement was assessed at four sections of the patient-specific aorta model. The displacement values of the flap varied from 0.5 to 3 mm along the model. This model provides a unique insight into aortic dissection flow patterns and pressure distributions. This dissection phantom model can be used to assess various treatment options based on the surgical, endovascular, or hybrid techniques.
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Affiliation(s)
- Liam Morris
- Galway-Mayo Institute of Technology, Galway, Ireland
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
- Medical and Engineering Technology Centre, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
- Lero – Science Foundation Ireland Research Centre for Software, Galway-Mayo Institute of Technology, Galway, Ireland
- *Correspondence: Liam Morris,
| | - Paul Tierney
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
- Medical and Engineering Technology Centre, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
| | - Niamh Hynes
- CÚRAM, National University of Ireland, Galway, Ireland
| | - Sherif Sultan
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, University College Hospital Galway, Galway, Ireland
- Department of Vascular and Endovascular Surgery, Galway Clinic, Royal College of Surgeons in Ireland, Doughiska, Ireland
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McHugo VS, Nolke L, Delassus P, MaCarthy E, McMahon CJ, Morris L. The impact of compliance on Stage 2 uni-ventricular heart circulation: An experimental assessment of the Bidirectional Glenn. Med Eng Phys 2020; 84:184-192. [PMID: 32977917 DOI: 10.1016/j.medengphy.2020.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/11/2020] [Accepted: 07/13/2020] [Indexed: 11/30/2022]
Abstract
The Bidirectional Glenn (BDG) or cavopulmonary connection is typically undertaken to volume unload the single ventricle in an effort to preserve ventricular and atrioventricular valve function. The geometry of this surgical palliation has been shown to influence the fluid energy loss as well as the distribution of flow that enters through the superior vena cava. In-vitro and in-silico studies to date have been performed on rigid wall models, while this investigation looks at the impact of flexible thin walled models versus rigid walls. Rigid and compliant models of two patient-specific Glenn geometries were fabricated and tested under various flow conditions, within a biosimulator capable of replicating patient specific flow conditions. It was found that the compliant models exhibit greater levels of energy loss compared to the rigid models. Along with these findings greater levels of turbulence was found in both compliant models compared to their rigid counterparts under ultrasound examinations. This shows that vessel compliance has a significant impact on the hemodynamics within hypoplastic left heart syndrome.
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Affiliation(s)
- V S McHugo
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland.
| | - L Nolke
- Department of Pediatric Cardiology Our Lady's Children's Hospital Crumlin, Dublin, Ireland; University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - P Delassus
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland
| | - E MaCarthy
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland
| | - C J McMahon
- Department of Pediatric Cardiology Our Lady's Children's Hospital Crumlin, Dublin, Ireland; University College Dublin School of Medicine, Belfield, Dublin, Ireland.
| | - L Morris
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland.
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McHugo S, Nolke L, Delassus P, MacCarthy E, Morris L, McMahon CJ. An in-vitro evaluation of the flow haemodynamic performance of Gore-Tex extracardiac conduits for univentricular circulation. J Cardiothorac Surg 2020; 15:235. [PMID: 32878643 PMCID: PMC7466829 DOI: 10.1186/s13019-020-01269-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE(S) The Fontan procedure is a common palliative intervention for sufferers of single ventricle congenital heart defects that results in an anastomosis of the venous return to the pulmonary arteries called the total cavopulmonary connection (TCPC). In patients with palliated single ventricular heart defects, the Fontan circulation passively directs systemic venous return to the pulmonary circulation in the absence of a functional sub-pulmonary ventricle. Therefore, the Fontan circulation is highly dependent on favourable flow and energetics, and minimal energy loss is of great importance. The majority of in vitro studies, to date, employ a rigid TCPC model. Recently, few studies have incorporated flexible TCPC models, without the inclusion of commercially available conduits used in these surgical scenarios. METHOD The methodology set out in this study successfully utilizes patient-specific phantoms along with the corresponding flowrate waveforms to characterise the flow haemodynamic performance of extracardiac Gore-Tex conduits. This was achieved by comparing a rigid and flexible TCPC models against a flexible model with an integrated Gore-Tex conduit. RESULTS The flexible model with the integrated Gore-Tex graft exhibited greater levels of energy losses when compared to the rigid walled model. With this, the flow fields showed greater levels of turbulence in the complaint and Gore-Tex models compared to the rigid model under ultrasound analysis. CONCLUSION This study shows that vessel compliance along with the incorporation of Gore-Tex extracardiac conduits have significant impact on the flow haemodynamics in a patient-specific surgical scenario.
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Affiliation(s)
- Shane McHugo
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering (GMIT), Galway, Ireland
| | - Lars Nolke
- Department of Cardiothoracic Surgery, Children's Health Ireland, Crumlin, Dublin 12, Ireland
| | - Patrick Delassus
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering (GMIT), Galway, Ireland
| | - Eugene MacCarthy
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering (GMIT), Galway, Ireland
| | - Liam Morris
- Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering (GMIT), Galway, Ireland
| | - Colin Joseph McMahon
- Department of Pediatric Cardiology Children's Health Ireland, Crumlin, Dublin 12, Ireland.
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
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Arokiaraj MC. Emergency coronary angioplasty with stenting using Cordis ® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters. Rev Port Cardiol 2018; 37:117-125. [PMID: 29426798 DOI: 10.1016/j.repc.2017.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/30/2017] [Accepted: 04/27/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION AND AIMS Difficulty in engaging with guide catheters is not uncommon in acute emergencies. We aimed to evaluate the use of Cordis® INFINITI diagnostic catheters to perform angioplasty in patients in whom the coronaries cannot be engaged using standard guide catheters. METHODS In 34 cases of acute coronary syndrome, when difficulty in engagement with two standard guide catheters was encountered with reasonable manipulations, angioplasty was performed using diagnostic catheters. In total, 40 stents were placed by this technique. Pushability and trackability, distal tip flexion and three-point bending tests were performed to evaluate the performance of the guide and diagnostic catheters. RESULTS Angioplasty was performed easily in a setting where it would have been very difficult to perform. Coronary dissection occurred in one patient, treated by a stent. The stent and dilatation balloons were easily passed through the diagnostic catheters. Pressure tracings were clearly preserved with certain stent delivery systems, and at angioplasty, although there was slightly reduced opacification of the respective artery, the coronary anatomy was sufficiently visualized to perform angioplasty. No periprocedural target lesion complications were seen in any cases. Pushability and trackability tests showed good force transmission along a tortuous path with diagnostic catheters, and balanced force-displacement curves from three-point bending tests and distal tip softness tests. CONCLUSION Angioplasty with stenting can be performed safely through 6F Cordis® infiniti diagnostic catheters when difficulty in engaging guide catheters is encountered.
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Emergency coronary angioplasty with stenting using Cordis® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2018.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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