1000–34 Facilitated Lumen Enlargement by Longitudinal Force Focused Angioplasty

By longitudinally concentrating dilating force, a guidewire (Gw) external to the balloon may facilitate PTCA mediated lumen enlargement. In vitro measurements showed a three-fold increment in the linearly directed dilating force at the interface of the external guidewire and the balloon. ACC/AHA type A or B lesions (n = 10) underwent Gw facilitated PTCA using an 0.012” guidewire as the “cutting wire,” and angiographic results were compare to a control group (n = 37) of lesions undergoing conventional PTCA. Download : Download high-res image (115KB) Download : Download full-size image The lesions yielded (no “waist”) at 4.3 Atm in the guidewire facilitated group and at 6.7 Atm in the control group (p = 0.005). During the first inflations, the balloon achieved 52% of the maximal balloon size at 2 Atm and 82% at 4 Atm. In the wire facilitated angioplasty group the final diameter stenosis was 21% vs. 29% in the control group (p = 0.001) with a device efficiency (EFF) (final minimal lumen diameter ÷ maximum balloon size) of 0.76 vs. 0.60 for the controls (p = 0.005). Conclusion The use of a guidewire external to the balloon increases pressure transmitted to the lesion, improves distensibility and lowers lesion yielding pressure. Longitudinal force focused PTCA has the potential to improve acute lumen dimensions, prevent spiral dissections and enhance device efficiency.