Nanto’s technique for changing a PTCA balloon catheter over a regular-length guide wire

Nanto’s technique for changing a PTCA balloon catheter over a regular-length guide wire

Nanto’s technique for changing a percutaneous transluminal coronary angioplasty (PTCA) balloon catheter over a regular-length guide wire is demonstrated in this video on youtube: http://www.youtube.com/watch?v=mjEjbSNL4IY (unfortunately the description audio is not in English).

One more video is available in Youtube at (again the description is not in English): https://www.youtube.com/watch?v=LXIJeKDcpQQ

This video shows exchange of a guidewire from a microcatheter. They emphasise that wiping the external part of the guidewire is an important step to remove clots on it. Common cause of failure of the technique is the presence of clots on the guidewire.

You may have to give a search on Youtube if the link has changed.

This technique is used for changing an over the wire balloon catheter with a regular length of guide wire. But in the 1994 description by Nanto an colleagues available on Pubmed [1], they connected the inflation device to the central guidewire lumen of the balloon catheter after pulling back the catheter until the proximal end of the guide wire was just inside. The balloon catheter was further pulled back while applying pressure with the inflation device, leaving the guide wire in the coronary artery. Nanto and colleagues could use this technique successfully in 149 of the 163 procedures attempted. In the youtube video (link above), they seem to have simplified it further by using just a filled luer lock syringe instead of the inflation device.

Reference

1. S Nanto, T Ohara, T Shimonagata, M Hori, S Kubori. A technique for changing a PTCA balloon catheter over a regular-length guidewire. Cathet Cardiovasc Diagn. 1994 Jul;32(3):274-7.