skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques

Abstract

PurposeThe purpose of the study was to retrospectively evaluate the efficacy and safety of the balloon blocking technique (BBT).Materials and MethodsThe BBT was performed in six patients (all males, mean 73.5 years) in whom superselective catheterization for transcatheter arterial embolization by the conventional microcatheter techniques had failed due to anatomical difficulty, including targeted arteries originating steeply or hooked from parent arteries. All BBT procedures were performed using Seldinger’s transfemoral method. Occlusive balloons were deployed and inflated at the distal side of the target artery branching site in the parent artery via transfemoral access. A microcatheter was delivered from a 5-F catheter via another femoral access and was advanced over the microguidewire into the target artery, under balloon blockage of advancement of the microguidewire into non-target branches. After the balloon catheter was deflated and withdrawn, optimal interventions were performed through the microcatheter.ResultsAfter success of accessing the targeted artery by BBT, optimal interventions were accomplished in all patients with no complications other than vasovagal hypotension, which responded to nominal therapy.ConclusionThe BBT may be useful in superselective catheterization of inaccessible arteries due to anatomical difficulties.

Authors:
 [1];  [2];  [1];  [3];  [1]
  1. Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan)
  2. Kyoto Prefectural University of Medicine, Department of Radiology, North Medical Center (Japan)
  3. Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan)
Publication Date:
OSTI Identifier:
22642516
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 6; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BRANCHING RATIO; CHANNELING; HYPOTENSION; PATIENTS; SAFETY; THERAPY; VASCULAR DISEASES

Citation Formats

Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp, E-mail: mori-h33@xa2.so-net.ne.jp, Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp, Ito, Takaaki, E-mail: takaaki@koto.kpu-m.ac.jp, Hayashi, Natsuko, E-mail: hayashin@koto.kpu-m.ac.jp, and Sato, Osamu, E-mail: osamu-sato@kyoto1-jrc.org. Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques. United States: N. p., 2016. Web. doi:10.1007/S00270-015-1271-4.
Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp, E-mail: mori-h33@xa2.so-net.ne.jp, Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp, Ito, Takaaki, E-mail: takaaki@koto.kpu-m.ac.jp, Hayashi, Natsuko, E-mail: hayashin@koto.kpu-m.ac.jp, & Sato, Osamu, E-mail: osamu-sato@kyoto1-jrc.org. Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques. United States. doi:10.1007/S00270-015-1271-4.
Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp, E-mail: mori-h33@xa2.so-net.ne.jp, Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp, Ito, Takaaki, E-mail: takaaki@koto.kpu-m.ac.jp, Hayashi, Natsuko, E-mail: hayashin@koto.kpu-m.ac.jp, and Sato, Osamu, E-mail: osamu-sato@kyoto1-jrc.org. 2016. "Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques". United States. doi:10.1007/S00270-015-1271-4.
@article{osti_22642516,
title = {Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques},
author = {Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp, E-mail: mori-h33@xa2.so-net.ne.jp and Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp and Ito, Takaaki, E-mail: takaaki@koto.kpu-m.ac.jp and Hayashi, Natsuko, E-mail: hayashin@koto.kpu-m.ac.jp and Sato, Osamu, E-mail: osamu-sato@kyoto1-jrc.org},
abstractNote = {PurposeThe purpose of the study was to retrospectively evaluate the efficacy and safety of the balloon blocking technique (BBT).Materials and MethodsThe BBT was performed in six patients (all males, mean 73.5 years) in whom superselective catheterization for transcatheter arterial embolization by the conventional microcatheter techniques had failed due to anatomical difficulty, including targeted arteries originating steeply or hooked from parent arteries. All BBT procedures were performed using Seldinger’s transfemoral method. Occlusive balloons were deployed and inflated at the distal side of the target artery branching site in the parent artery via transfemoral access. A microcatheter was delivered from a 5-F catheter via another femoral access and was advanced over the microguidewire into the target artery, under balloon blockage of advancement of the microguidewire into non-target branches. After the balloon catheter was deflated and withdrawn, optimal interventions were performed through the microcatheter.ResultsAfter success of accessing the targeted artery by BBT, optimal interventions were accomplished in all patients with no complications other than vasovagal hypotension, which responded to nominal therapy.ConclusionThe BBT may be useful in superselective catheterization of inaccessible arteries due to anatomical difficulties.},
doi = {10.1007/S00270-015-1271-4},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 39,
place = {United States},
year = 2016,
month = 6
}
  • The techniques for superselective catheterization of hepatic artery are described. The catheters have five major configurations in various sizes: (1) simple curve, (2) reverse curve, (3) double curve, (4) modified double curve, and (5) hepatic and splenic curves. Since the celiac artery may be directed caudad, horizontally, or cephalad, the techniques vary accordingly. The basic approach of the system described is to tailor the catheter to fit the vascular anatomy. These various techniques have produced a 95% success rate in the hepatic artery catheterization of 1000 patients.
  • PurposeApproximately 83 % of patients with bladder cancer have achieved a complete response after undergoing a novel bladder preservation therapy involving balloon-occluded intra-arterial infusion chemotherapy (BOAI) using a four-lumen double-balloon catheter, known as the Osaka Medical College regimen. This study aimed to show the quantitative difference in hemodynamics of the bladder arteries using syngo iFlow (Siemens Healthcare, Erlangen, Germany), which provides an automatic tool for quantitative blood flow analysis between double BOAI (D-BOAI) and conventional single BOAI (S-BOAI).Materials and MethodsFifty patients were included. The catheters were introduced into both posterior trunks of the internal iliac arteries via contralateral femoral artery access.more » A side hole between the distal and proximal balloons was placed at the origin of each bladder artery to allow clear visualization of angiographic flow of the injected agent into the urinary bladder. Digital subtraction angiography was used during analysis with the syngo iFlow to evaluate the hemodynamics of the contrast medium in the pelvic arteries during BOAI. The comparative change in the amount of contrast medium in the bladder arteries between D-BOAI and S-BOAI was assessed using syngo iFlow.ResultsOne-hundred pelvic sides were analyzed. The amount of contrast medium in the bladder arteries using D-BOAI was more than twice that using S-BOAI (right, 3.03-fold; left, 2.81-fold).ConclusionThe amount of contrast medium in the bladder arteries using D-BOAI was higher than that using conventional S-BOAI. This may increase the anticancer drug concentration in the affected bladder, leading to a good clinical response.« less
  • Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks.more » Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic lymph nodes experienced a high rate of distant metastases.« less