Navitian: The option when no balloon crosses the lesion

Dr. Ignacio J. Amat Santos
Dr. Ignacio J. Amat Santos

Director of interventional cardiology of the Hospital Clínico Universitario de Valladolid, Spain.

Patient profile

  • 58 years-old men
  • Cardiovascular risk factors: diabetes mellitus type 2, dyslipidaemia, active smoking.
  • Cardiovascular history: Haemodynamically stable and with chronic stable angina.

Lesion type

  • Severe and calcified lesion with 95% severity of the middle anterior descending artery (Figure 1).

Procedure

  • An antegrade procedure was performed starting with LM cannulation using a XB 3.5 guide catheter.
  • Sion Blue guidewire was advanced (Figure 2). An attempt was made to advance the balloon antegrade, which proved impossible due to a severe calcified lesion in the middle LAD.
  • The Navitian was advanced through the lesion without difficulty (Figure 3) and exchanged for Rotawire.
  • Rotational atherectomy with 1.50 mm olive (Figure 4), predilatation with 2.50x15 mm balloon scoring and 3.00x40 mm DES implantation was successfully performed (Figure 5, 6).

Conclusion

"Navitian demonstrates a great crossing capacity compared to conventional balloons where it advances without difficulty through the lesion, simplifying the procedure. In the presence of complex situations, Navitian’s features can help simplify complex procedures."

Dr. Ignacio J. Amat Santos

Figures
Figure 1. Severe and calcified lesion of LAD
Figure 1. Severe and calcified lesion of LAD
Figure 2. Sion BLUE wire advancement
Figure 2. Sion BLUE wire advancement
Figure 3. Navitian easily crossing the lesion
Figure 3. Navitian easily crossing the lesion
Figure 4. Rotational atherectomy
Figure 4. Rotational atherectomy
Figure 5. DES implantation
Figure 5. DES implantation
Figure 6. Final angiographic result
Figure 6. Final angiographic result
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