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The Missing Link…Thierry Lefèvre, Institut Hospitalier Jacques Cartier, Massy, France
The Missing Link… Thierry Lefèvre, Institut Hospitalier Jacques Cartier, Massy, France
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One of the technical limitations of coronary angioplasty lies in the potential difficulties in accessing the lesion to be dilated. Access may indeed be difficult and time consuming, requiring substantial effort, a considerable volume of contrast media as well as prolonged X-ray exposure. In some instances, it may even prove to be totally impossible. Various factors may generate difficulties. These may arise in the presence of extreme tortuosities precluding the accurate manoeuvering of the distal tip of the angioplasty guide wire, or wide angles hard to negotiate in some bifurcation lesions (Fig 1). Other complex situations may be the access to a septal branch in alcohol septal ablation procedures, retrograde approach via a saphenous or mammary graft (Fig 2), passage through stent struts(Fig 3), or certain instances of chronic total occlusions where no stump is visible (Fig 4).
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The Venture catheter is a simple tool which facilitates access to these complex lesions. Easy control of the catheter distal tip during the procedure enables the operator to create an angle of up to 120°. The system is available in monorail or coaxial versions. In our experience, this device has allowed us to treat successfully lesions which would have been inaccessible using a conventional system. Uneasy manoeuvering in small size vessels (>2.5mm) constitutes the only limitation of the device. Though still not very much in use, the Venture catheter should be considered as indispensable a tool as the rotablator or thrombectomy devices. |
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