Is Postdilatation with a Noncompliant Balloon Necessary after Coronary Stent Deployment during Primary Angioplasty?

Journal of Interventional Cardiology - Tập 26 Số 4 - Trang 325-331 - 2013
Abdurrahman Taşal1, Ahmet Bacaksız1, Mehmet Akıf Vatankulu1, Murat Turfan1, Ercan Erdoğan1, Osman Sönmez1, Şeref Kul1, Gökhan Ertaş1, Emrah Sevgili1, Ömer Uysal1
1Bezmialem Foundation University Department of Cardiology Istanbul Turkey

Tóm tắt

AbstractBackgroundPostdilatation (PD) with noncompliant balloon during elective percutaneous coronary intervention (PCI) is performed usually in clinical practice in order to optimize stent expansion. However, current knowledge about its use in patients undergoing primary PCI is controversial. This study aims to evaluate the angiographical and clinical results of PD in patients who underwent primary PCI with drug eluting stents (DESs).MethodsA total of 405 consecutive patients (mean age 56.9 ± 12.3 years; 302 male) with ST elevation myocardial infarction were evaluated retrospectively. Patients received DES with or without predilatation according to physician's discretion. Eligible patients were divided into 2 groups based on PD procedure. The clinical end‐points were death, target vessel revascularization (TVR) and stent thrombosis at 6 months after PCI. The angiographic end‐points were postprocedural correct Thrombolysis in Myocardial Infarction (TIMI) frame count (cTFC), final TIMI flow, and myocardial blush grade (MBG).ResultsPD was performed in 214 patients (52.8%). Angiographical parameters such as TIMI flow, cTFC, and MBG did not differ after PD (P > 0.05). During 6‐month follow‐up, TVR and stent thrombosis rates were lower in the PD group (6 vs. 16, P = 0.03; and 3 vs. 10, P = 0.04, respectively). PD and diabetes were detected as independent predictors of MACE (β = 0.52, P = 0.01, and β = −0.47, P = 0.02; respectively).ConclusionOur study revealed that PD does not yield adverse effects on final angiographic parameters when performed during primary PCI. Besides PD seems to decrease probability of stent thrombosis and TVR.

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Journal of Interventional Cardiology

Tập 26 Số 4

325-331

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