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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Predicting Side Branch Occlusion in Acute Coronary Syndrome Using the Perfusion Balloon.

Hiroshi Abe1, Dai Ozaki1, Haruhiko Hara1

  • 1Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 24, 2025
PubMed
Summary

Perfusion balloon side branch-assisted flow stability (PB-SAFE) effectively predicts side branch occlusion in acute coronary syndrome patients. Maintaining side branch flow during intervention prevents occlusion, unlike cases with flow loss.

Keywords:
PB‐SAFEacute coronary syndromebifurcation lesionpercutaneous coronary interventionperfusion balloon

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Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Percutaneous Coronary Intervention

Background:

  • Coronary bifurcation lesions represent 20% of percutaneous coronary interventions.
  • Assessing thrombotic risk in these lesions remains challenging.
  • No established methods exist for predicting side branch occlusion in thrombus-containing bifurcations.

Purpose of the Study:

  • To evaluate perfusion balloon dilatation as a predictor of side branch occlusion.
  • To assess the utility of side branch flow during intervention for risk stratification.

Main Methods:

  • 38 acute coronary syndrome patients with 65 side branches were analyzed.
  • Percutaneous coronary intervention utilized a perfusion balloon.
  • Branches were categorized into PB-SAFE (flow maintained) and not-SAFE (flow loss) groups based on intra-procedural flow.

Main Results:

  • No side branch occlusion occurred in the PB-SAFE group.
  • Side branch occlusion occurred in 31.7% of not-SAFE group branches.
  • The not-SAFE group was a significant independent predictor of side branch occlusion (aOR 20.8, p<0.01).

Conclusions:

  • Perfusion balloon side branch-assisted flow stability (PB-SAFE) is a novel predictor of side branch occlusion.
  • This method can identify patients at high risk for side branch occlusion during PCI for ACS bifurcation lesions.