Jailed Semi-Inflated Balloon Technique (JSBT) for Preserving Side Branch Viability During Chronic Total Occlusion (CTO) Intervention

Bilal Ahmed; Faisal Ahmed

Authors

Bilal Ahmed Liaquat National Hospital, Karachi-Pakistan
Faisal Ahmed Liaquat National Hospital, Karachi-Pakistan

Keywords:

Chronic Total Occlusion, Jailed Semi-Inflated Balloon Technique, Percutaneous Coronary Intervention, Side Branch Patency, Revascularization

Abstract

Background: Chronic total occlusion (CTO) of the coronary arteries poses significant challenges in managing coronary artery disease. Successful intervention is essential for improving patient outcomes, particularly in cases with prior history of coronary interventions. The Jailed Semi-Inflated Balloon Technique (JSBT) has emerged as a valuable strategy to enhance side branch patency during CTO procedures, thereby preserving viable vessels and reducing the risk of ischemia.

Case Presentation: A 58-year-old male with a significant medical history, including diabetes, hypertension, and ischemic heart disease, presented to the outpatient department with persistent retrosternal chest discomfort lasting for six months, despite optimal medical therapy.

Results: The intervention involved a provisional bifurcation stenting strategy, utilizing JSBT in the right ventricular marginal branch to preserve flow in this viable vessel during the CTO recanalization. The procedure was successful, leading to good stent expansion and maintaining patency without complications.

Conclusion: This case underscores the critical importance of preserving as many viable vessels as possible during CTO interventions. The implementation of JSBT not only facilitated successful revascularization but also enhanced overall outcomes, reducing the risk of future ischemic events.

References

Muraca I, Carrabba N, Virgili G, Bruscoli F, Migliorini A, Pennesi M, Pontecorboli G, Marchionni N, Valenti R. Chronic total occlusion revascularization: A complex piece to" complete" the puzzle. World J Cardiol. 2022;14(1):13.

Stone GW, Kandzari DE, Mehran R, Colombo A, Schwartz RS, Bailey S, Moussa I, Teirstein PS, Dangas G, Baim DS, Selmon M. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I. Circulation. 2005;112(15):2364-2372.

Syukri M, Mahendra I, Zulkarnain H, Leona DF. Provisional Stenting Techniques Using A Novel Modified Jailed Balloon. INSOLOGI: Jurnal Sains dan Teknologi. 2022;1(6):777-787.

Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165.