OBJECTIVES: To perform the kissing balloon technique (KBT) with a 5 Fr guide catheter. BACKGROUND: Since the KBT requires 6 Fr or larger guide catheters with regular coronary systems, it is impossible to perform the KBT in a 5 Fr guide catheter. METHODS: A 5 Fr guide accepts new, smaller-diameter balloons (Ikazuchi-10) for the KBT. The key components were the use of 0.010 inch guidewires and specialized balloons for a 0.010 inch guidewire. We examined the data comparison in the manufacturer's catalog, performed in vitro experiments for trackability and animal experiments to test the KBT with a 5 Fr guide, and performed the first clinical case of the KBT with a 5 Fr guide. RESULTS: The data derived from the manufacturer's catalog (Kaneka Medics, Tokyo, Japan) showed that the distal shaft of the Ikazuchi-10 (2.1 Fr) was smaller than any other balloon catheter (2.4-2.6 Fr). An in vitro trackability test showed that the Ikazuchi-10 had lower resistance when passing through a bent portion. In a porcine model, we safely performed the KBT. The first clinical case of protected left main bifurcation was treated successfully with the KBT using a 5 Fr guide catheter. CONCLUSIONS: It is feasible to perform the KBT in a 5 Fr guide catheter using 0.010 guidewires and 0.010 inch compatible balloons.
OBJECTIVES: To perform the kissing balloon technique (KBT) with a 5 Fr guide catheter. BACKGROUND: Since the KBT requires 6 Fr or larger guide catheters with regular coronary systems, it is impossible to perform the KBT in a 5 Fr guide catheter. METHODS: A 5 Fr guide accepts new, smaller-diameter balloons (Ikazuchi-10) for the KBT. The key components were the use of 0.010 inch guidewires and specialized balloons for a 0.010 inch guidewire. We examined the data comparison in the manufacturer's catalog, performed in vitro experiments for trackability and animal experiments to test the KBT with a 5 Fr guide, and performed the first clinical case of the KBT with a 5 Fr guide. RESULTS: The data derived from the manufacturer's catalog (Kaneka Medics, Tokyo, Japan) showed that the distal shaft of the Ikazuchi-10 (2.1 Fr) was smaller than any other balloon catheter (2.4-2.6 Fr). An in vitro trackability test showed that the Ikazuchi-10 had lower resistance when passing through a bent portion. In a porcine model, we safely performed the KBT. The first clinical case of protected left main bifurcation was treated successfully with the KBT using a 5 Fr guide catheter. CONCLUSIONS: It is feasible to perform the KBT in a 5 Fr guide catheter using 0.010 guidewires and 0.010 inch compatible balloons.