Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions

Minh N. Vo, Georgios Christopoulos, Dimitri Karmpaliotis, William L. Lombardi, J. Aaron Grantham, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: After successful guidewire passage, failure to cross the occluded segment with a balloon is the most common cause of procedural failure in coronary chronic total occlusion (CTO) intervention. We evaluated the safety and efficacy of the balloon-assisted microdissection (BAM) technique for treating these complex balloon-uncrossable lesions. METHODS: We identified consecutive cases treated with BAM for balloon-uncrossable CTOs between January 2012 and February 2015 at two experienced CTO percutaneous coronary intervention (PCI) centers and reviewed their clinical and angiographic characteristics and procedural outcomes. RESULTS: During the study period, a total of 17 patients had BAM performed for balloon-uncrossable CTOs. Mean age was 65.5 ± 8.7 years and 94% of patients were males who often had prior myocardial infarction, PCI, and coronary artery bypass graft surgery. The most common CTO target vessel was the right coronary artery. Mean J-CTO score was 2.6 ± 1.1. Despite high lesion complexity, overall procedural success was 94% and BAM facilitated success in approximately one-half of these cases. All BAM failure cases except 1 were successfully recanalized utilizing additional techniques. No patient experienced a major complication. CONCLUSION: BAM is a simple, inexpensive, and safe technique that can facilitate crossing of balloon-uncrossable CTOs and can be considered as first-line treatment for these complex lesions.

Original languageEnglish (US)
Pages (from-to)E37-E41
JournalJournal of Invasive Cardiology
Volume28
Issue number4
StatePublished - Apr 1 2016

Fingerprint

Microdissection
Percutaneous Coronary Intervention
Coronary Artery Bypass
Coronary Vessels
Myocardial Infarction
Transplants
Safety

Keywords

  • balloon uncrossable
  • chronic total occlusion
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Vo, M. N., Christopoulos, G., Karmpaliotis, D., Lombardi, W. L., Grantham, J. A., & Brilakis, E. S. (2016). Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions. Journal of Invasive Cardiology, 28(4), E37-E41.

Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions. / Vo, Minh N.; Christopoulos, Georgios; Karmpaliotis, Dimitri; Lombardi, William L.; Grantham, J. Aaron; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 28, No. 4, 01.04.2016, p. E37-E41.

Research output: Contribution to journalArticle

Vo, MN, Christopoulos, G, Karmpaliotis, D, Lombardi, WL, Grantham, JA & Brilakis, ES 2016, 'Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions', Journal of Invasive Cardiology, vol. 28, no. 4, pp. E37-E41.
Vo MN, Christopoulos G, Karmpaliotis D, Lombardi WL, Grantham JA, Brilakis ES. Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions. Journal of Invasive Cardiology. 2016 Apr 1;28(4):E37-E41.
Vo, Minh N. ; Christopoulos, Georgios ; Karmpaliotis, Dimitri ; Lombardi, William L. ; Grantham, J. Aaron ; Brilakis, Emmanouil S. / Balloon-Assisted Microdissection "bAM" Technique for Balloon-Uncrossable Chronic Total Occlusions. In: Journal of Invasive Cardiology. 2016 ; Vol. 28, No. 4. pp. E37-E41.
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