Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques
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The purpose of the study was to retrospectively evaluate the efficacy and safety of the balloon blocking technique (BBT).
Materials and Methods
The BBT was performed in six patients (all males, mean 73.5 years) in whom superselective catheterization for transcatheter arterial embolization by the conventional microcatheter techniques had failed due to anatomical difficulty, including targeted arteries originating steeply or hooked from parent arteries. All BBT procedures were performed using Seldinger’s transfemoral method. Occlusive balloons were deployed and inflated at the distal side of the target artery branching site in the parent artery via transfemoral access. A microcatheter was delivered from a 5-F catheter via another femoral access and was advanced over the microguidewire into the target artery, under balloon blockage of advancement of the microguidewire into non-target branches. After the balloon catheter was deflated and withdrawn, optimal interventions were performed through the microcatheter.
After success of accessing the targeted artery by BBT, optimal interventions were accomplished in all patients with no complications other than vasovagal hypotension, which responded to nominal therapy.
The BBT may be useful in superselective catheterization of inaccessible arteries due to anatomical difficulties.
KeywordsSelective catheterization Balloon catheter Transcatheter arterial embolization
The authors thank Takeshi Nishimura, MD (Department of Gastroenterology, North medical Center, Kyoto Prefectural University of Medicine), Hidetaka Takashima, MD (Department of Gastroenterology, Fukuchiyama City Hospital), Takashi Ueda, MD (Department of Urology, Kyoto Prefectural University of Medicine), Takanori Inui, MD, Yusuke Ichijo, MD, and Koji Masui, MD (Department of Radiology, Kyoto Prefectural University of Medicine), for their help in patients management, Hideki Ehara, MD, and Sachiko Koshino, MD (Department of Diagnostic Radiology, Japan Red Cross Kyoto Daiichi Hospital), for their help in preparing manuscript, Takeshi Shinohara, Misa Nishino, and Noriaki Ohba (CRO Company Clinical Information Division, EPS Corporation) for technical support in statistical data analysis, and Kei Yamada, MD, PhD (Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine), for supervising the study.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflicts of interest.
Statement of Informed Consent
Written informed consent was obtained from all individual participants included in this study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
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