PTCA with side‐by‐side balloon using fixed guide wire systems: A potential alternative autoperfusion device‐an in vitro study

Colle, J.P.; Delarche, Nicolas

doi:10.1002/ccd.1810270412

Cited by 3 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the early days of coronary angioplasty, an auto perfusion balloon angioplasty catheter was used for long balloon inflation, which was based on the hypothesis that the loose flap of dissection may be definitively “tacked back” and might deliver a better result [ 22 – 24 ]. Another study found that approximately half of patients whose initial angioplasty failed could be treated by prolonged balloon dilation [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled clinical trial of prolonged balloon inflation during stent deployment strategy in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a pilot study

Diao

Liang

et al. 2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background Primary percutaneous coronary intervention (PPCI) is the standard procedure for reperfusion for ST-segment elevation myocardial infarction (STEMI), but the occurrence of the no-reflow phenomenon remains common and is associated with adverse outcomes. Aims This study aimed to evaluate whether prolonged balloon inflation in stent deployment would lessen the occurrence of the no-reflow phenomenon in PPCI compared with conventional rapid inflation/deflation strategy. Methods Patients were randomly assigned to either the prolonged balloon inflation in stent deployment group (PBSG) or conventional deployment strategy group (CDSG) in a 1:1 ratio. A subset of patients was included in the cardiac magnetic resonance (CMR) assessment. Results Thrombolysis in MI (TIMI) flow grade 3 was found in 96.7% and 63.3% of the patients of the PBSG and CDSG, respectively (P = 0.005). The results of the PBSG and CDSG are respectively shown as follows: 0% versus 30% no-reflow or slow flow (P = 0.002); 90% versus 66.7% ST-segment resolution ≥ 50% (P = 0.028); 35.6 ± 14.5 frames versus 49.18 ± 25.2 frames on corrected TIMI frame count (P = 0.014); and 60% versus 20% myocardial blush grade 3 (P = 0.001). At 1 month, the major cardiovascular adverse event (cardiovascular mortality) rate was 3.3% in both groups; at 1 year, the rate was 3.3% and 6.7% for the PBSG and CDSG, respectively (P = 1.00). In the CMR subset of cases, the presence of microvascular obstruction (MVO) was detected in 6.7% and 50% of the patients in the PBSG and CDSG, respectively (P = 0.023). Conclusion In our pilot trial, prolonged balloon inflation during stent deployment strategy in PPCI reduces the occurrence of the no-reflow phenomenon in patients with STEMI and improved the myocardial microcirculation perfusion (ClinicalTrials.gov number: NCT03199014; registered: 26/June/2017).

show abstract

Section: Discussionmentioning

confidence: 99%

A randomized controlled clinical trial of prolonged balloon inflation during stent deployment strategy in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a pilot study

Diao

Liang

et al. 2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…In the early days of coronary angioplasty, an autoperfusion balloon angioplasty catheter was used for long balloon inflation, which was based on the hypothesis that the loose flap of dissection may be definitively "tacked back" and might deliver a better result [22][23][24]. A human study found that in approximately half of patients whose initial angioplasty was a failure, could be reverted to a success by prolonged dilation [25].…”

Section: Procedural Outcomesmentioning

confidence: 99%

A Randomized Controlled Clinical Trial of Prolonged Stent Deployment Strategy in Primary Percutaneous Coronary Intervention for ST-segment Elevation Myocardial Infarction: A Pilot study

Ma¹,

Wang²,

Yang³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Primary percutaneous coronary intervention (PPCI) is the most standard reperfusion strategy for ST-segment elevation myocardial infarction (STEMI), but the no-reflow phenomenon is still common and is associated with adverse outcomes. Little is known about the consequences of different strategies of deploying stents on outcomes in STEMI patients. The aim of this study was to evaluate whether prolonged inflation would decrease the no-reflow phenomenon in PPCI compared with the conventional rapid inflation/deflation strategy. Methods This was a prospective, single-center, blinded, randomized controlled trial. Patients were randomized 1:1 to a prolonged deployment strategy group or a conventional deployment strategy group. A subset of patients was included in a cardiac magnetic resonance (CMR) examination assessment. The primary outcomes were the number of patients with Thrombolysis in Myocardial Infarction (TIMI) flow grade 3, the incidence of intraoperative no-reflow/slow flow, the corrected TIMI frame count, the myocardial blush grade, and the number of patients with ST-segment resolution>50%. The secondary outcome was major cardiovascular adverse events at one month and one year following the index PPCI. Results TIMI flow grade 3 was found in 96.7% of the prolonged deployment strategy group and 63.3% of the conventional deployment group (P=0.005). The prolonged inflation strategy and inflation/deflation strategy group respectively showed the following rates: 0% vs 30% no-reflow or slow flow (P=0.002); 90% vs 66.7% ST-segment resolution ≥50% (P=0.028); 35.6±14.5 frames vs 49.18±25.2 frames on corrected TIMI frame count (P=0.014); and 60% vs 20% myocardial blush grade 3 (P=0.001). The major cardiovascular adverse event rate was 3.3% in both groups at one month and 3.3% for the prolonged inflation strategy group vs 6.7% for the rapid inflation/deflation strategy group at one year (P=1.0). In the CMR subset of cases, the presence of microvascular obstruction (MVO) was detected in 6.7% of patients in the prolonged inflation strategy group and in 50% of patients in the rapid inflation/deflation strategy group (P=0.023). Conclusions In the patients with STEMI who underwent PPCI, the effect of the prolonged inflation strategy could decease the no-reflow phenomenon and improve myocardial microcirculation perfusion, but there were no benefits for the 30-day or one-year clinical outcomes. (ClinicalTrials.gov number: NCT03199014.Registered June 23, 2017,http://https://clinicaltrials.gov/ct2/show/NCT03199014?term=NCT03199014&cntry=CN&draw=2&rank=1)

show abstract

Perfusion Therapy to Reduce Myocardial Ischemia En Route to Emergency Coronary Artery Bypass Grafting for Failed Percutaneous Transluminal Coronary Angioplasty

Paik

Kuntz

Baim

1995

J Interven Cardiology

View full text Add to dashboard Cite

Despite improvements in operator technique, catheter technology, and the development of new devices, emergency coronary artery bypass grafting (CABG) is still required in 1%-4% of attempted catheter based revascularization procedures. Patients who require such emergency CABG after failed percutaneous transluminal coronary angioplasty (PTCA) have worse acute outcomes than those undergoing elective CABG, with a higher incidence of Q wave myocardial infarction (MI) and a higher operative mortality. In patients with otherwise refractory abrupt closure, maintenance of antegrade coronary blood flow using perfusion catheters lessens the incidence of Q wave MI and lowers peak creatinine phosphokinase. Direct maintenance of coronary flow thus appears to provide more definitive control of myocardial ischemia than purely adjunctive measures, such as intra-aortic balloon pumping, cardiopulmonary support, or coronary sinus retroperfusion. Although the recent introduction of coronary stents holds great promise for definitive percutaneous reversal of abrupt closure and a dramatic decrease in the incidence of emergency CABG for failed PTCA, maintenance of antegrade flow via perfusion technology remains the cornerstone of management in reducing the perioperative mortality and morbidity of patients who still require emergency bypass surgery after failed PTCA.

show abstract

PTCA with side‐by‐side balloon using fixed guide wire systems: A potential alternative autoperfusion device‐an in vitro study

Cited by 3 publications

References 15 publications

A randomized controlled clinical trial of prolonged balloon inflation during stent deployment strategy in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a pilot study

A randomized controlled clinical trial of prolonged balloon inflation during stent deployment strategy in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a pilot study

A Randomized Controlled Clinical Trial of Prolonged Stent Deployment Strategy in Primary Percutaneous Coronary Intervention for ST-segment Elevation Myocardial Infarction: A Pilot study

Perfusion Therapy to Reduce Myocardial Ischemia En Route to Emergency Coronary Artery Bypass Grafting for Failed Percutaneous Transluminal Coronary Angioplasty

Contact Info

Product

Resources

About