One feature of this catheter, as indicated by its name, is the presence of a compliant balloon attached proximally to decrease blood flow in order to secure a good anterior visual field. Complete blockage of blood flow by maximally inflating the balloon is not necessary. In clinical use, lactated Ringer’s or low molecular weight dextran-L is flashed from the head in order to prevent retrograde blood flow coming from the anterior direction or side branches due to collateral circulation. Hence, a small degree of residual antegrade blood flow does not create a problem. Inflating the balloon may not be necessary during the observation of small vessels. For these reasons, the method of inflating the equipped balloon using CO₂ gas, while checking the monitor after flashing, has been widely adopted, replacing the traditional method of inflating the balloon with a diluted contrast agent under fluoroscopic guidance. While an inflated balloon cannot be checked with this method, the advantage is that inflation time can be shortened and an air vacuum is not required.

Observation with this catheter can be carried out with a 0.014-in. guidewire used for PCI in the coronary artery, which is also common for other imaging devices. Furthermore, using a proximally located slider, the tip of the fiber can move forward and backward on the guidewire with its support. By blocking off blood flow once, observation in a broader area is made possible. Furthermore, since the guidewire becomes a supporting device, the fiber can pass closer to the center of the inner cavity, contributing to a wider visual field.

Because each unit is integrated, operation after insertion is straightforward. However, despite the various functions mentioned above, understanding the role of each part and making thorough preparations prior to insertion are vital. Since this system must be connected to an exterior equipment, cooperation and communication with healthcare professionals such as clinical engineers are important.