Intracoronary focal nitroglycerin injection through drilled balloon is very effective in the resolution of coronary spasm versus into proximal coronary artery: A prospective randomized comparison study

Balaban, Yakup; Kaya, Ahmet; Satilmisoglu, Mustafa H.; Balaban, M.

doi:10.1111/joic.12542

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…800µg NTG diluted in 10 cc isotonic NaCl solution was infused through the catheter after vessel recanalization in the study. This dose of GTN is close however slightly higher than previous coronary artery research in which 200-500ug GTN was given through a catheter (19)(20)(21)(22)(23). Our study suggests that 800µg is safe for post recanalization cerebral administration.…”

Section: Discussionmentioning

confidence: 42%

Arterial Glyceryl Trinitrate in Acute Ischemic Stroke After Thrombectomy for Neuroprotection (AGAIN): A Pilot Randomized Controlled Trial

Cheng,

Gao,

Ding

et al. 2023

Neurotherapeutics

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Section: Discussionmentioning

confidence: 42%

Arterial Glyceryl Trinitrate in Acute Ischemic Stroke After Thrombectomy for Neuroprotection (AGAIN): A Pilot Randomized Controlled Trial

Cheng,

Gao,

Ding

et al. 2023

Neurotherapeutics

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“…Notably, rapid administration of intracoronary nitrate following provocative testing has resulted in no reported procedure-related deaths[ 13 ]. Furthermore, recent studies have demonstrated more efficacy and safety with local administration of nitroglycerin to spasming areas through a perforated balloon rather than proximal administration of nitroglycerin, which may further reduce minor risks associated with provocative testing[ 33 ] . The impact of local nitroglycerin administration on a spasming area of coronary artery can be visualized in Figures 1 and 2 .…”

Section: Diagnosticsmentioning

confidence: 99%

Coronary vasospasm: A narrative review

Jewulski¹,

Khanal²,

Dahal³

2021

WJC

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Coronary artery vasospasm (CAVS) plays an important role in acute chest pain syndrome caused by transient and partial or complete occlusion of the coronary arteries. Pathophysiology of the disease remains incompletely understood, with autonomic and endothelial dysfunction thought to play an important role. Due to the dynamic nature of the disease, its exact prevalence is not entirely clear but is found to be more prevalent in East Asian and female population. Cigarette smoking remains a prominent risk factor, although CAVS does not follow traditional coronary artery disease risk factors. Many triggers continue to be identified, with recent findings identifying chemotherapeutics, allergens, and inflammatory mediators as playing some role in the exacerbation of CAVS. Provocative testing with direct visualization is currently the gold-standard for diagnosis, but non-invasive tests, including the use of biomarkers, are being increasingly studied to aid in the diagnosis. Treatment of the CAVS is an area of active research. Apart from risk factor modification, calcium channel blockers are currently the first line treatment, with nitrates playing an important adjunct role. High-risk patients with life-threatening complications should be considered for implantable cardioverter defibrillator (ICD), although timing criteria for escalated therapy require further investigation. The role of pharmaceuticals targeting oxidative stress remains incompletely understood.

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“…Achievement of NTG administration was determined by the occurrence of at least 20 mmHG drops in arterial blood pressure. the other hand, coronary vasospasm is involved in the etiopathogenesis of ACS and may cause a lower estimation of preferred stent size in where the stent will be placed as well as increases myocardial ischemia [6]. Thus, intracoronary NTG is frequently used during coronary angiography to identify reversible coronary vasospasm.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Intracoronary Nitroglycerine Administration on Lesion Parameters, Intervention Success and 1-Year MACE in Patients with Acute Coronary Syndromes

Duman¹,

Elif²,

Hamur³

et al. 2022

Int J Clin Cardiol

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Aims: Nitroglycerine (NTG) was used to relieve ischemic symptoms in patients with coronary artery disease. However, some studies demonstrated the positive effects of NTG on coronary circulation. In addition, NTG has been administrated to evaluate culprit lesion characteristics during coronary angiography. It was aimed to evaluate the effects of intracoronary NTG administration prior to percutaneous coronary intervention (PCI) on lesion severity and outcome prediction in patients with acute coronary syndrome (ACS).Methods: A total of 312 consecutive patients diagnosed with ACS were included in the study and followed-up for 1 year. Major adverse cardiovascular events (MACE) was defined as cardiovascular death, new-onset decompensated heart failure, cerebrovascular event, sustained ventricular tachycardia and/or fibrillation within the 48 hours after the procedure.Results: A total of 312 ACS patients (184 Unstable Angina/ NSTEMI, 128 STEMI) were included in the study. A total of 212 patients were administered to the intracoronary nitroglycerin pre-PCI group (Mean ± standard deviation of age was 63 ± 12 years and 82% of patients were male) and 100 patients to the untreated group (Mean ± standard deviation of age was 61 ± 11 years and 84% of patients were male). Intracoronary NTG did not cause a significant change in lesion length. Total leukocyte count (p = 0.005), Hba1c level (p = 0.031), pre-hospital beta blocker usage (p < 0.001), and stent post-dilatation (p = 0.020) were found to be independent predictors of MACE. NTG administration changed lesion parameters and reference vessel diameters significantly. Conclusion:Intracoronary NTG administration had no predictive value on the one-year MACE. However, it was associated with coronary perfusion parameters and severity of the coronary lesion.

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Intracoronary focal nitroglycerin injection through drilled balloon is very effective in the resolution of coronary spasm versus into proximal coronary artery: A prospective randomized comparison study

Abstract: The local administration of NTG to a spasming area through a perforated balloon is more effective and safer than the proximal administration of NTG.

Cited by 6 publications

References 18 publications

Arterial Glyceryl Trinitrate in Acute Ischemic Stroke After Thrombectomy for Neuroprotection (AGAIN): A Pilot Randomized Controlled Trial

Arterial Glyceryl Trinitrate in Acute Ischemic Stroke After Thrombectomy for Neuroprotection (AGAIN): A Pilot Randomized Controlled Trial

Coronary vasospasm: A narrative review

The Effects of Intracoronary Nitroglycerine Administration on Lesion Parameters, Intervention Success and 1-Year MACE in Patients with Acute Coronary Syndromes

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