Balloon Anchor Techniques for Sheath, Guide Catheter, and Stent Advancement and to Facilitate Chronic Total Occlusion Traversal

Advancement of a sheath or guide catheter into a small, diseased or angled branch vessel such as the superior mesenteric artery or renal artery can be difficult. Similarly, there are times when placement of a sheath up and over a sharply angulated aortic bifurcation can present a challenge. Obtaining a sheath position at or beyond a stenotic or occlusive lesion may be critical for delivering a stent, particularly with the inherent risk of dislodgment associated with balloon-expandable stents. The use of balloons as anchors has been described most commonly in the coronary vasculature, but it can have an important role in peripheral and visceral applications. This chapter discusses the utility of balloons as an anchor to advance a sheath or stent to a target location.