Retrieve the scaffold into the guiding catheter
Coronary scaffold loss complications
What is the technique and material necessary for retrieval of a scaffold into the guiding catheter using low pressure balloon inflation? When should you not apply force? How do you align correctly with the guide catheter and when do you abandon this approach? These and other question are dealt with in this complications section.
Retrieval of the scaffold by using a low-profile angioplasty balloon is a technique used as an attempt in the some patients because it does not require specially designed kit1. A low-profile angioplasty balloon (1.5-2.0 mm diameter, 20 mm length) is advanced on the guidewire and passed through the unexpanded scaffold. This is possible as the uninflated diameter of the tip is <0.6mm. The balloon is then inflated distally to the scaffold (at 3 atmospheres) and can then be used to gently pull back the scaffold into the guiding catheter. Once the scaffold is secured between the balloon and the guiding catheter and removed through the arterial sheath en bloc. The technique can only be implemented without any resistance or damage or foreshortening of the scaffold. If the scaffold does not come back then the technique should be abandoned.
Extract from The PCR Textbook: Volume II Intervention I - Part III, Chapter 24: The prevention and management of complications during percutaneous coronary intervention (PCI)
Small balloon inflation technique
Key messages
- Always check the balloon markers
- Inspect the scaffold / balloon after retrieval
- Do not apply force if the balloon has moved
- Do not remove the guidewire
- Attempt to deploy the scaffold in situ
- Alignment with the guiding catheter in case of retrieval
Disclaimer
This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.