ENDOLUMINAL SEALING OF VASCULAR WALL DISRUPTIONS WITH RADIOFREQUENCY-HEATED BALLOON ANGIOPLASTY

Suboptimal luminal widening or acute closure secondary to arterial dis section remain significant risks of percutaneous transluminal balloon angioplasty. Non surgical techniques are often employed in an attempt to repair dissections either as temporary or definitive treatment. The aim of this study was to test the hypothesis that radiofrequency ther mal balloon angioplasty at an operating temperature of 70-degrees-C an d low inflation pressure could seal dissections and perforations in a model of severe arterial wall damage. Dissections and perforations wer e created in renal (n = 4) and carotid (n = 4) arteries in four mongre l dogs. Endoluminal sealing was then attempted with conventional ballo on angioplasty or radiofrequency thermal balloon angioplasty (2 atm at 70-degrees-C). Contrast dye extravasation persisted in all cases foll owing conventional balloon angioplasty but completely resolved with ra diofrequency balloon angioplasty in all but one artery. Histologic exa mination of the arteries treated with radiofrequency balloon angioplas ty showed extensive thermal injury. including transmural coagulation n ecrosis, flattening of the internal elastic lamina, and medial thinnin g. On the basis of these results, the utility of thermal balloon angio plasty for endoluminal sealing of dissections and perforations complic ating angioplasty deserves further evaluation.