Influence of balloon pressure inflation in patients undergoing primary coronary stent implantation during acute myocardial infarction: a quantitative coronary angiography analysis

Mattos, Luiz Alberto; Sousa, Amanda G.M.R.; Chaves, Áurea J.; Feres, Fausto; Pinto, Ibraim; Tanajura, Luiz Fernando; Centemero, Marinella; Abizaid, Alexandre; Seixas, Ana C.; Abizaid, Andréa S.; Maldonado, Galo; Staico, Rodolfo; Sousa, J. Eduardo

doi:10.1590/s0066-782x2003000300002

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…Similar to our results, Mattos et al conducted a study involving 82 patients to study the effect of balloon pressure inflation (yet in patients undergoing primary PCI for acute myocardial infarction) and stated that the acute lumen gain was similar between the high-and low-pressure deployment groups (0.8±0.1 vs 0.9±0.1, P=0.13). 40 We found no statistically significant difference between the two study groups as regards MACE, unstable angina, or rehospitalization rate after 6 months. Similar to our results, Dirschinger et al found no statistically significant difference between the high-and low-pressure deployment groups as regards clinical outcome at 1-year follow-up.…”

Section: Discussionmentioning

confidence: 53%

Impact of stent deployment pressure and poststenting dilatation on the outcome of elective percutaneous coronary intervention

Nour¹

2016

RRCC

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Background: High-pressure stent deployment was proposed as a strategy that ensures complete stent apposition but its relation to outcome is markedly debated. Objective: To verify the influence of stent deployment pressure and poststenting dilatation on the outcome of percutaneous coronary intervention. Methods: We included 120 patients with single vessel coronary artery disease who were subjected to elective stenting. Patients were divided into two groups: group A, high deployment pressure ≥16 atm and group B, low deployment pressure 8-12 atm. Group B was subdivided into two subgroups according to whether patients underwent poststenting dilatation (subgroup B1) or not (subgroup B2). Clinical and angiographic 6-month follow-up was performed. Results: The mean stent deployment pressure was higher in group A compared to group B (19±3 vs 10±2, P=0.01). There was no statistically significant difference found between groups A and B regarding major adverse cardiac events (16.7% vs 23.3%, P=0.404) including target lesion revascularization (5% vs 6.7%, P=0.970) and late loss (1.1 mm ±0.9 mm vs 1.22 mm ±0.85 mm, P=0.454), yet the restenosis rate was significantly lower in group A (23.3% vs 43.3%, P=0.032). Subgroup B1 showed a significantly lower restenosis rate compared to subgroup B2 (26.7% vs 60%, P=0.018), yet there was no significant difference between both subgroups regarding major cardiac adverse events (20% vs 26.7%, P=0.761). Conclusion: High-pressure stent deployment was associated with significant reduction in the restenosis rate but not in the 6 months major adverse cardiac events. Poststenting dilatation resulted in a significantly lower restenosis rate when applied in the low-pressure stent deployment group.

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Section: Discussionmentioning

confidence: 53%

Impact of stent deployment pressure and poststenting dilatation on the outcome of elective percutaneous coronary intervention

Nour¹

2016

RRCC

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“…However, in a randomized study, there were no significant differences concerning the risk of ISR when using low or high inflation pressure during stent implementation ( 24 ). Another study analyzed moderate to high balloon inflation pressure during PCI and found no measurable improvement in late outcome ( 25 ). Finally, a recent retrospective study on over 90,000 stent implementations suggests that a low and a very high pressure elevates the risk of ISR ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with intra‑stent restenosis after percutaneous coronary intervention

et al. 2021

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The present study aimed to explore the correlations between clinical, biological, imagistic and procedural factors with the risk of intra-stent restenosis (ISR) in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). An observational cross-sectional study was conducted in a high-volume PCI center over a period of 2 years. A total of 235 consecutive patients diagnosed with angina or acute coronary syndrome treated by PCI were included in the study. Diagnosis of ISR was documented by coronary angiography in patients with suggestive coronary symptoms and ischemic changes in non-invasive or invasive paraclinical investigations. Thus, they were assigned to two groups: With or without ISR. All patients underwent clinical and laboratory examination, providing clinical and paraclinical variables that could be considered risk factors for ISR. Current smokers [risk ratio (RR)=1.63; 95% confidence interval (95% CI): 1.25-2.13], arterial hypertension (RR=1.86; 95% CI: 1.41-2.45), diabetes (RR=1.83; 95% CI: 1.42-2.36), high C-reactive protein (CRP) levels (RR=1.44; 95% CI: 0.93-2.24), chronic kidney disease (CKD) (RR=1.90; 95% CI: 1.53-2.36) and thrombolysis in myocardial infarction (TIMI) score were found to have a significant role in estimating the risk for ISR. Moreover, the ISR group (119 patients) presented with a lower stent inflation pressure when compared to the control group (116 patients) (14.47 vs. 16.14 mmHg, P=0.004). An increased mean stent diameter used for PCI was not associated with a high ISR incidence (P=0.810) as well as complex coronary treated lesions with longer stents (mean length of 24.98 mm in patients without ISR vs. 25.22 mm in patients with ISR; P=0.311). There was an estimated two times higher risk (RR=2.13; 95% CI: 1.17-3.88) concerning multi-stenting and restenosis degree >70%. To conclude, smoking, hypertension, diabetes mellitus, high CRP levels, CKD, TIMI score, stent type, low pressure for stent implantation and multi-stenting were found to be associated with ISR in patients following PCI. Therefore, a close follow-up should be targeted in such patients.

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Influence of balloon pressure inflation in patients undergoing primary coronary stent implantation during acute myocardial infarction: a quantitative coronary angiography analysis

Abstract: During AMI stenting, the use of high pressures (> or = 16 atm) did not cause a measurable improvement in late outcome, either in the late loss, its index, and the net gain, or in clinical and angiographic restenosis rates.

Cited by 2 publications

References 43 publications

Impact of stent deployment pressure and poststenting dilatation on the outcome of elective percutaneous coronary intervention

Impact of stent deployment pressure and poststenting dilatation on the outcome of elective percutaneous coronary intervention

Risk factors associated with intra‑stent restenosis after percutaneous coronary intervention

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