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Investigation of the small-balloon technique as a method for retrieving dislodged stents

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Abstract

The small-balloon technique used to retrieve a dislodged coronary stent is less studied. We investigated the small-balloon technique to study the capture force and retrieval rate of dislodged proximal or distal stents. We developed a retrieval model for stent dislodgement and performed bench tests to compare proximal and distal capture. We evaluated capture force by capture site in a fixed stent dislodgement model and capture force and retrieval rate by capture site using a retrieval model of stent dislodgement. Three-dimensional (3D)-micro-computed tomography (CT) was used to scan the captured conditions of the distal (DC) and proximal (PC) groups. Stent, balloon shaft, and guiding catheter (GC) diameters were measured. Retrieval areas within GC were calculated and compared. The force was significantly lower in the PC group than in the DC group (p < 0.01). Successful retrieval was achieved in 100% and 84.8% in the PC and DC groups, respectively. The force required to retrieve the dislodged stent was significantly lower in the PC group than that in the DC group (p < 0.01). The force was significantly lower in the successful cases in the DC group than in the unsuccessful cases (p < 0.01). The retrievable areas in the PC and DC groups were 67.5% and 32.7%, respectively, as calculated from the values measured from the 3D-CT images. The success rate of PC was higher than that of DC using the small-balloon technique. The smaller proximal stent gap in the PC method facilitated the retrieval of the dislodgement stent.

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Data availability

The datasets generated and/or analyzed during the current study are available from the first author upon reasonable request.

Abbreviations

PC:

Proximal capture

DC:

Distal capture

GC:

Guiding catheter

BMS:

Bare metal stent

PCI:

Percutaneous coronary intervention

POBA:

Plain old balloon angioplasty

DES:

Drug-eluting stent

GW:

Guidewire

LAD:

Left anterior descending artery

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Acknowledgements

We would like to thank the Terumo Corporation for providing us with the experimental site, materials, and equipment for this study as well as Mr. Asai, Mr. Kaneko, and Mr. Fujimaki for their cooperation.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Takayuki Ogawa, Yasunori Inoue, Takatoku Aizawa, Satoshi Morimoto, Kazuo Ogawa, Tomohisa Nagoshi, Kosuke Minai, Makoto Kawai & Michihiro Yoshimura

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  1. Takayuki Ogawa
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  2. Yasunori Inoue
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  3. Takatoku Aizawa
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  4. Satoshi Morimoto
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  5. Kazuo Ogawa
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  6. Tomohisa Nagoshi
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  7. Kosuke Minai
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  8. Makoto Kawai
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  9. Michihiro Yoshimura
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by KO and TO. The first draft of the manuscript was written by TO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takayuki Ogawa.

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Conflict of interest

This article was supported by Terumo Corporation, which provided the experimental site, materials and equipment. T.O also reports lecture fee from Terumo Corporation in association with this article. Outside this study, T.O reports lecture fees from Abbott Medical Japan, Boston Scientific Corporation, Kaneka Corporation, Otsuka Pharmaceutical Co. Ltd and Takeda Pharmaceutical Co. Ltd. M.Y. reports lecture fees from Daiichi Sankyo Co. Ltd, Mitsubishi Tanabe Pharma Corporation, Pfizer Japan Inc, AstraZeneca K.K, Astellas Pharma Inc, Bayer Yakuhin Ltd; grants and lecture fees from Otsuka Pharmaceutical Co. Ltd and Mochida Pharmaceutical Co and grants from Teijin Pharma Ltd and Shionogi & Co., Ltd.

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Ogawa, T., Inoue, Y., Aizawa, T. et al. Investigation of the small-balloon technique as a method for retrieving dislodged stents. Cardiovasc Interv and Ther 38, 309–315 (2023). https://doi.org/10.1007/s12928-023-00917-y

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  • DOI: https://doi.org/10.1007/s12928-023-00917-y

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