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Long Inflation at Stent Deployment in Intravascular Ultrasound-Guided Percutaneous Coronary Intervention for Acute
Yusuke Watanabe1, Kenichi Sakakura1, Hiroyuki Jinnouchi1
1Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University Saitama Japan.
Insights
Single-step long balloon inflation during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) improved flow but did not significantly alter final TIMI 3 flow rates. This method may enhance final Thrombolysis in Myocardial Infarction (TIMI) flow.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Slow flow during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a significant risk.
- This can lead to adverse patient outcomes.
- Optimizing coronary blood flow post-PCI is crucial for improving AMI prognosis.
Purpose of the Study:
- To evaluate if single-step long balloon inflation during stent deployment improves final Thrombolysis in Myocardial Infarction (TIMI) flow grade.
- To compare final TIMI flow grade and delta TIMI flow grade in intravascular ultrasound (IVUS)-guided PCI for AMI.
- To assess the impact of long balloon inflation versus conventional inflation on coronary flow.
Main Methods:
- Retrospective analysis of 336 AMI patients undergoing IVUS-guided PCI.
- Patients divided into long inflation (≥60s) and conventional inflation groups.
- Primary endpoints: final TIMI flow grade 3 and delta TIMI flow grade.
Main Results:
- The long inflation group had a significantly higher initial TIMI thrombus grade.
- Final TIMI 3 flow rates were similar between groups (90% vs. 88.5%).
- Delta TIMI flow grade was significantly greater in the long inflation group (P=0.028).
Conclusions:
- Single-step long balloon inflation is a simple and feasible technique.
- It may be beneficial for achieving optimal final TIMI flow in IVUS-guided PCI for AMI.
- This approach warrants consideration for improving coronary reperfusion.
Background:
There is a substantial risk of slow flow during percutaneous coronary intervention (PCI) for the culprit lesion in acute myocardial infarction (AMI), which can lead to adverse outcomes. We hypothesized that single-step long balloon inflation during stent deployment was associated with a more favorable final Thrombolysis in Myocardial Infarction (TIMI) flow grade. This retrospective study aimed to compare both the final TIMI flow grade and the delta TIMI flow grade in intravascular ultrasound (IVUS)-guided PCI for AMI between patients with long balloon inflation and those with conventional inflation.
Methods And Results:
Long inflation was defined as single-step inflation ≥60 s at stent deployment. The primary endpoints were achievement of the final TIMI flow grade 3 and the delta TIMI flow grade, defined as the difference between the initial and final grades. We analyzed 336 AMI patients with attenuation plaque on IVUS, dividing them into a long inflation group (n=50) and a conventional inflation group (n=286). Despite a significantly higher TIMI thrombus grade in the long inflation group (P<0.001), the rate of the final TIMI 3 flow was similar (90% vs. 88.5%; P=1.00). However, the delta TIMI flow grade was significantly greater in the long inflation group (P=0.028).
Conclusions:
Single-step long balloon inflation may be a simple and feasible method to achieve optimal final TIMI flow in IVUS-guided PCI for AMI.
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