Balloon sizing of pulmonary branch stenosis: a useful method to guide stent implantation.
Among patients with congenital heart disease, pulmonary branch stenosis is a common indication for stent implantation. Selective calibrated angiography is the standard method of vessel sizing to guide angioplasty balloon and stent selection. Our aim was to compare vessel dimensions from standard calibrated selective angiography with those obtained using a compliant sizing balloon catheter.


METHODS
9 patients with 11 pulmonary branch stenoses underwent selective calibrated angiography. Amplatzer sizing balloon catheters positioned across the stenoses were inflated with dilute contrast agent. Digital angiograms were repeated in the same projections. Measurements from both methods were analyzed statistically. Minimum, maximum proximal and maximum distal vessel diameters were all significantly larger (p < 0.01) when measured by the sizing balloon method. Angioplasty balloons and stent diameters were chosen according to the sizing balloon measurements. In 7 of 8 stented lesions, larger angioplasty balloon diameters were selected for stent implantation than would have been chosen by standard angiography. Calibrated selective angiography may undersize vessel diameters. Use of a compliant sizing balloon appears to offer an accurate method to guide stent implantation in pulmonary branch stenosis.
Nagm
Ashraf M
AM
Mattel Children s Hospital at UCLA, 108333 Le Conte Avenue, B2-427 MDCC, Los Angeles, CA, 90095-1743, USA.
Moore
John W
JW
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design / Q000295:instrumentation; D006801:Humans; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome