Kissing balloon technique within a 5 Fr guiding catheter using 0.010 inch guidewires and 0.010 inch guidewire-compatible balloons.
OBJECTIVE
To perform the kissing balloon technique (KBT) with a 5 Fr guide catheter.


BACKGROUND
Since the KBT requires 6 Fr or larger guide catheters with regular coronary systems, it is impossible to perform the KBT in a 5 Fr guide catheter.


METHODS
A 5 Fr guide accepts new, smaller-diameter balloons (Ikazuchi-10) for the KBT. The key components were the use of 0.010 inch guidewires and specialized balloons for a 0.010 inch guidewire. We examined the data comparison in the manufacturer's catalog, performed in vitro experiments for trackability and animal experiments to test the KBT with a 5 Fr guide, and performed the first clinical case of the KBT with a 5 Fr guide.


RESULTS
The data derived from the manufacturer's catalog (Kaneka Medics, Tokyo, Japan) showed that the distal shaft of the Ikazuchi-10 (2.1 Fr) was smaller than any other balloon catheter (2.4-2.6 Fr). An in vitro trackability test showed that the Ikazuchi-10 had lower resistance when passing through a bent portion. In a porcine model, we safely performed the KBT. The first clinical case of protected left main bifurcation was treated successfully with the KBT using a 5 Fr guide catheter.


CONCLUSIONS
It is feasible to perform the KBT in a 5 Fr guide catheter using 0.010 guidewires and 0.010 inch compatible balloons.
Yoshimachi
Fuminobu
F
Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan. ikari@is.icc.u-tokai.ac.jp
Masutani
Motomaru
M
Matsukage
Takashi
T
Saito
Shigeru
S
Ikari
Yuji
Y
D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography; D004195:Disease Models, Animal; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013552:Swine