Short- and long-term outcomes of Wiktor stent implantation at low versus high pressures

Yang, Paul; Gyöngyösi, Mariann; Hassan, Ali; Heyer, Günter; Klein, W.; Luha, O.; Maurer, E.; Mühlberger, V.; Pachinger, Othmar; Sochor, Heinz; Sykora, Josef; Weber, H; Weidinger, Franz; Glogar, Dietmar

doi:10.1016/s0002-9149(99)00409-9

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…A randomized, multicenter clinical trial carried out between 1995 and 1996 in Austria evaluated whether high-pressure post-dilation of Wiktor stents provided short- and long-term benefits compared to the conventional low-pressure implantation without post-dilation. Their results showed that initial lumen gain by high-pressure post-dilation did not translate into improved long-term clinical outcomes (ie, death, MI, or target lesion revascularization) 21. This trial indirectly supports our results of a lack of association with reduced need for repeat revascularization with post-dilation.…”

Section: Discussionsupporting

confidence: 82%

Differential effects of post-dilation after stent deployment in patients presenting with and without acute myocardial infarction

Zhang

Marroquin

Stone

et al. 2010

American Heart Journal

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Background In the practice of percutaneous coronary intervention (PCI), post-dilatation often is performed after stent deployment to improve stent expansion. However, aggressive mechanical expansion is a risk factor of distal embolization and microvascular injury, especially for patients with acute myocardial infarction (AMI). Few studies have investigated the effects of post-dilatation on medium-term clinical outcomes. Methods and Results Patients enrolled in the multicenter NHLBI Dynamic Registry between 2001 and 2006 were evaluated. Patients who were treated with ≥1 stent were studied. Patients with cardiogenic shock or history of coronary artery bypass graft surgery were excluded. Patients were followed up to 1 year. Because of the significant statistical interaction (P = .02) between post-dilatation and AMI status on the hazard of death/myocardial infarction (MI), post-dilatation effects were estimated separately for patients who did and did not present with an AMI. Among the 1,358 patients who presented with an AMI, post-dilatation was associated with a significantly higher risk of death/MI (hazard ratio [HR] = 1.78, 95% CI 1.12-2.83, P = .01), not associated with the risk of repeat revascularization (HR = 1.15, 95% CI 0.81-1.62, P = .43). Among the 2,699 patients who did not present with AMI, post-dilatation was not associated with risks of death/MI (HR = 1.08, 95% CI 0.77-1.50, P = .67) or repeat revascularization (HR = 1.17, 95% CI 0.93-1.47, P = .19). Similar effects were observed for the restricted analysis with additional adjustment for lesion characteristics among the 1,039 AMI patients and 2,179 non-AMI patients with a single lesion treated. Conclusions Stent post-dilatation is associated with an increased risk of death/MI in AMI patients but not in non-AMI patients. Further investigation is warranted.

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Section: Discussionsupporting

confidence: 82%

Differential effects of post-dilation after stent deployment in patients presenting with and without acute myocardial infarction

Zhang

Marroquin

Stone

et al. 2010

American Heart Journal

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“…The pressure used during the implantation of a stent has a very significant effect on the result of angioplasty . The choice of guidewire is of key significance in the course of the procedure to give the correct support and to advance it through tortuous calcified vessels.…”

Section: Discussionmentioning

confidence: 99%

“…The pressure used during the implantation of a stent has a very significant effect on the result of angioplasty. [14][15][16][17][18][19] The choice of guidewire is of key significance in the course of the procedure to give the correct support and to advance it through tortuous calcified vessels. In the study of Eleny Villanuevy et al 20 and in their paper published in 2016, 21 human tissues or cells).…”

Section: Discussionmentioning

confidence: 99%

The effects of types of guidewires and pressure applied during stent implantation in the main vessel on the incidence of damage to coronary guidewires during angioplasty of coronary bifurcation lesions—Wide Beast study

Kwiatkowski¹,

Małachowski

Jakubas-Kwiatkowska

et al. 2018

J Interven Cardiology

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“…Whereas higher balloon pressures potentially maximises stent expansion and residual lumen size, this strategy also likely results in greater vascular trauma, which may in turn elicit more aggressive neointimal hyperplasia (14,15).…”

Section: Position Of the Stentmentioning

confidence: 99%

Pathophysiology of coronary artery in‐stent restenosis

Kibos

Tintoiu

2007

Acute Cardiac Care

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In-stent restenosis reflects the interaction of a cascade of molecular and cellular events occurring within the vessel wall. Coronary stenting induces localized injury to the vessel wall, which leads to the release of thrombogenic, vasoactive, and lymphocytes mitogenic factors that result in processes causing re-narrowing at the injured site. Three major processes have been identified that lead to the in-stent restenosis: neointimal hyperplasia, elastic recoil, and negative arterial remodeling. The most important one is intimal hyperplasia. As the time course of neointimal hyperplasia is unknown, a causal relationship between the development of new blood vessels and clinical restenosis cannot be firmly established.

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Short- and long-term outcomes of Wiktor stent implantation at low versus high pressures

Cited by 12 publications

References 17 publications

Differential effects of post-dilation after stent deployment in patients presenting with and without acute myocardial infarction

Differential effects of post-dilation after stent deployment in patients presenting with and without acute myocardial infarction

The effects of types of guidewires and pressure applied during stent implantation in the main vessel on the incidence of damage to coronary guidewires during angioplasty of coronary bifurcation lesions—Wide Beast study

Pathophysiology of coronary artery in‐stent restenosis

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