Capbuster

Several challenges may arise for the clinician performing an interventional procedure on coronary arteries with chronic total occlusion. One such challenge is that of an impenetrable plaque. Possible solutions to this problem include active and passive support techniques, as well as devices such as the Tornus (Asahi Intech, Japan) and the Turnpike Gold (Teleflex, USA). However, these devices require high passive support and they are not always effective.

The CapBuster (Capsos Medical, Ireland) is a balloon catheter combined with a special guide wire designed to perforate impenetrable plaques. The microcatheter balloon is inflated inside the coronary artery, proximal to the plaque. This balloon provides, within the coronary artery, the active support required to allow the guidewire to be advanced through the plaque. Another of its benefits is that, once inflated, the tip of the microcatheter centers in the coronary artery to ensure an excellent central, coaxial alignment with the plaque.

One the balloon is inflated, the guidewire is advanced as if it were a lag screw: it is turned clockwise to advance it and, one the plaque has been crossed, it is turned anticlockwise to remove it. Once the plaque has been penetrated, a standard guidewire for chronic total occlusion can be used as per the interventionist’s choice.

It is estimated that the CapBuster will obtain the CE mark in 2021. Until then, we will have to wait be this device that, in theory, will help solve these important problems.

Palabras clave: placa coronaria impenetrable, oclusión coronaria crónica. Keywords: uncrossable coronary plaque, chronic total occlusion.