Fogarty and percutaneous transluminal coronary angioplasty balloon injury induce comparable damage to the arterial wall but lead to different healing responses

Abstract

Despite comparable endothelial cell abrasion and medial necrosis, Fogarty balloon injury elicited significantly augmented intimal hyperplasia compared with PTCA balloon dilation.

The genous™ endothelial progenitor cell capture stent accelerates stent re‐endothelialization but does not affect intimal hyperplasia in porcine coronary arteries

“…The mere presence of an endothelial layer is no guarantee for prevention or reduction of NIT. Doornekamp et al demonstrated that the substrate on which endothelium grows in vivo, determines its effect on NIT [33]. They removed the basement membrane through withdrawal of Fogarty balloons and compared results to percutaneous transluminal angioplasty (PTCA) balloons.…”

“…Pre‐existing disease is most often induced by endothelial injury with or without additional factors like an atherogenic diet or diabetes. Endothelial injury is most often induced by Fogarty denudation and results are quite different from denudation with PTCA balloons [33] most likely due to removal of the basement membrane. As such, that model is not necessarily clinically relevant.…”

Fogarty technique in the left main coronary artery

“…For most obstructed coronary arteries, balloon angioplasty is preferred for causing less endothelial damage, and less myointimal hyperplasia than Fogarty technique. 18 Nevertheless, in 2016, Larralde et al published a case of STEMI successfully treated using Fogarty technique, after failure of thrombus aspiration and balloon angioplasty, in the presence of occlusion, probably caused by embolus. 19 This unusual case of probable coronary embolization showed, in the presence of refractory LMCA occlusion leading to shock with cardiorespiratory arrest, the Fogarty technique using the ineffective angioplasty balloon prompted immediate hemodynamic recovery, thus eluding the need for interventional methods that would have demanded more time and materials.…”

Prolonged versus brief balloon inflation during arterial angioplasty for de novo atherosclerotic disease: protocol for a systematic review

“…Conversely, in addition to being a therapeutic treatment for atherosclerotic disease, balloon angioplasty is known to cause vascular damage to previously healthy arteries in animal models after an inflation time of 60 s [5–7]. These articles present several proposed mechanisms for arterial injury during angioplasty; however, they all ultimately refer to intimal hyperplasia which occurs within hours to days after the initial angioplasty, due to inflammatory response following endothelial injury caused by the balloon inflation.…”