Clinical Experience with Very High-Pressure Dilatation for Resistant Coronary Lesions

Secco, Gioel Gabrio; Buettner, A.; Parisi, Rosario; Pistis, Gianfranco; Vercellino, Matteo; Audo, Andrea; Mashayekhi, Kambis; Garbo, Roberto; Porto, Italo; Tarantini, Giuseppe; Mario, Carlo Di

doi:10.1016/j.carrev.2019.02.026

Cited by 55 publications

(26 citation statements)

References 13 publications

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“…Previous studies have revealed that HPB is superior to BA in the treatment of coronary atherosclerotic stenosis [16]. Furthermore, a few studies have demonstrated that dilation of AVF stenosis requires higher pressure than that of atherosclerotic stenosis [17], which is consistent with the results of the present meta-analysis (at 3 months and 6 months after operation).…”

Section: Discussionsupporting

confidence: 91%

Efficacy of high-pressure balloon for the treatment of arteriovenous fistula stenosis: a meta-analysis

Liu

Wang

Zhang

et al. 2021

Preprint

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Objective: The objective of the present study was to compare the effectiveness of high-pressure balloon (HPB) versus conventional balloon angioplasty (BA) in treating arteriovenous fistula (AVF) stenosis. Materials and Methods: A meta-analysis was conducted using data acquired from PubMed, EMBASE, the Cochrane Library, SinoMed, CNKI, WanFang and VIP databases from the time the databases were established to November 2020. All analyses included in the studies comprised the subgroups of HPB and BA. The patency of AVF was compared between the two groups at 3 months, 6 months and 12 months after operation. Results: Nine studies comprising 475 patients were included in the meta-analysis. The pooled results revealed that stenosis rate of AVFs treated with HPB was significantly lower than that of AVFs treated with conventional balloon at 3 months (OR= 0.37, 95% CI 0.21 to 0.67, p<0.001) and 6 months after operation (OR= 0.33, 95% CI 0.15 to 0.75, p=0.008). In addition, the technical success rate of HPB groups was high (OR= 0.14, 95% CI 0.05 to 0.35, p<0.001). However, no significant difference was observed between the experimental and control groups at 12 months after operation (OR= 0.61, 95% CI 0.29 to 1.25, p=0.18). No significant publication bias was observed in the analyses. Conclusion: HPB is a potential primary option for the treatment of AVF stenosis, with a lower 3- and 6-month stenosis rate than BA. However, the long-term effect of HPB was not satisfactory; therefore, further research should be conducted to elucidate the relationship between the two groups.

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Section: Discussionsupporting

confidence: 91%

Efficacy of high-pressure balloon for the treatment of arteriovenous fistula stenosis: a meta-analysis

Liu

Wang

Zhang

et al. 2021

Preprint

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“…In restricted clinical experience, the OPN NC balloon successfully treated >90% of undilatable lesions compared with a conventional NC balloon with a 0.9% rate of coronary rupture. [33] The OPN balloon is compatible with 0.014 inch wires and 5 Fr access, but it has a high profile (0.028 inches), although this is better than scoring and cutting balloons, and so it is difficult to recross or reuse after inflation.…”

Section: Percutaneous Coronary Intervention Of Complex Calcified Coromentioning

confidence: 99%

Contemporary Approach to Heavily Calcified Coronary Lesions

et al. 2019

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Percutaneous treatment of heavily calcified coronary lesions still represents a challenge for interventional cardiology, with higher risk of immediate complications, late failure due to stent underexpansion and malapposition, and consequently poor clinical outcome. Good characterisation of calcium distribution with multimodal imaging is important to improve the successful treatment of these lesions. The use of traditional or new dedicated devices for the treatment of calcified lesions allows better lesion preparation; therefore, it is important that we know the different mechanisms and technical features of these devices.

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“…Ultrahigh pressure noncompliant balloon, OPN NC (Sis‐Medical, Switzerland), is double‐layered and specially designed to be inflated up to 40 atm. The OPN balloon ranges from 1.5–4.5 mm in diameter with high reported procedural success (>92%) and low rates of coronary perforation in small studies 43,44 . There is limited availability of this device and larger trials are required to assess their effectiveness and safety.…”

Section: Lesion Modification Techniques and Devicesmentioning

confidence: 99%

“…high reported procedural success (>92%) and low rates of coronary perforation in small studies. 43,44 There is limited availability of this device and larger trials are required to assess their effectiveness and safety.…”

Section: Lesion Modification Techniques and Devicesmentioning

confidence: 99%

Breaking the deadlock of calcified coronary artery lesions: A contemporary review

Fan

Tong

Mintz

et al. 2020

Cathet Cardio Intervent

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Percutaneous coronary intervention (PCI) of severely calcified lesions is known to result in lower procedural success rates, higher complication rates, and worse longterm clinical outcomes compared to noncalcified lesions. Adequate lesion preparation through calcium modification is crucial in ensuring procedural success and reducing adverse cardiovascular outcomes. There are numerous calcium modification devices currently available whose usefulness depends on the nature of the calcific disease and its anatomical distribution. It can be challenging for the interventionists to decide which device is best suited for their patient. There is also emerging evidence for intravascular imaging in guiding selection of calcium modification devices using parameters such as calcium distribution and depth that directly impact on procedural success and clinical outcomes. In this review we aim to discuss the pathophysiology of coronary calcification, evaluate strategies and technologies of calcium modification and propose an AM A -S-A algorithm in managing calcified coronary lesions.

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Clinical Experience with Very High-Pressure Dilatation for Resistant Coronary Lesions

Cited by 55 publications

References 13 publications

Efficacy of high-pressure balloon for the treatment of arteriovenous fistula stenosis: a meta-analysis

Efficacy of high-pressure balloon for the treatment of arteriovenous fistula stenosis: a meta-analysis

Contemporary Approach to Heavily Calcified Coronary Lesions

Breaking the deadlock of calcified coronary artery lesions: A contemporary review

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