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The anatomic challenges of percutaneous endovascular stenting of aorto-ostial lesions remain a difficult task with low technical success, higher complication rates and increased target vessel restenosis rates. We sought to evaluate feasibility, efficacy, and safety of the Ostial Flash (Access Closure, Santa Clara, CA) balloon for treating aorto-ostial disease.
We retrospectively reviewed all the patients treated in our lab for aorto-ostial coronary or peripheral artery disease between December 2011 and May 2014. Every case where the Ostial Flash(OF) balloon was attempted was analyzed. Procedural characteristics, clinical characteristics, and 6 months clinical follow-up data were collected and analyzed.
Total of 229 patients were treated for aorto-ostial lesions involving coronary, saphenous bypass graft, renal, mesenteric, or subclavian lesions. In 136 (97.14%) of the 140 patients the OF balloon was used successfully as intended during the procedure. (Table) In 4 patients (2 RCA, 1 LM and 1 Renal) the OF balloon use was unsuccessfull. Complications included: 1 perforation in ostial RCA requiring a covered stent, 1 dissection at the distal edge of the stent requiring second stent, 1 transient hemodynamic instability (LM) and one case of deformity of contralateral renal stent At 6 months follow-up the clinical restenosis rate was relatively low (Table).
Ostial Flash balloon can be used to treat aorto-ostial lesions via radial as well as femoral approach with high success rate and low complication rate. The use of ostial flash may reduce proximal lesion miss and restenosis rate.