Case presentation
Endovascular treatment was performed for an 89-year-old male with a
symptomatic chronic total occlusion in the right superficial femoral
artery (Figure 1A). After crossing the chronic total occlusion with a
0.014-inch wire, a red clot was collected by catheter thrombectomy. A
5.0 x 40-mm-long non-slip element percutaneous transluminal balloon
angioplasty (NSE PTA) —a scoring balloon— (Nipro Corporation, Osaka,
Japan) was inflated three times without shaft rotation (NSE three
inflations) (Figure 1B). After that, angiography showed no significant
dissection (Figure 1C). In addition, five of the scores induced by the
NSE PTA balloon were detected by optical frequency domain imaging (OFDI)
(Terumo Corporation, Tokyo, Japan) (Figure 1D).
We previously evaluated the efficacy of NSE three inflations to reduce
the severe dissection in the treatment of femoropopliteal lesions
[1]. In that study, when the NSE three inflations performed with a
NSE PTA balloon, the elements shift of NSE PTA balloon could detect in
vitro experiment, while could not in patients with intravascular
ultrasound (IVUS) due to the insufficient resolution of IVUS.
The resolution of OFDI is approximately 10 times greater than that of
IVUS [2], OFDI could detect the scores induced by the NSE PTA
balloon. Moreover, OFDI detected five scores after the NSE three
inflations. Because the NSE PTA balloon has three elements, the image of
OFDI proved the elements shift of the NSE PTA balloon when the NSE three
inflations was performed in a patient.