PTCA in angulated segments: Effects of balloon material, balloon length, and inflation sequence on straightening forces in an in vitro model

Barasch, Eddy; Conger, Jeff L.; Kadipaşaoǧlu, Kâmuran A.; Peters, Jeff J.; Nesdahl, Kevin; Fenimore, Johnathan G.; Wilson, James M.; Vaughn, William K.; Ferguson, James J.

doi:10.1002/(sici)1097-0304(199610)39:2<207::aid-ccd23>3.0.co;2-c

Cited by 5 publications

(3 citation statements)

References 11 publications

(6 reference statements)

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“…This suggests that SES may not increase neointimal proliferation after PCI at the edge of the stent in angulated lesions. Barasch et al reported that noncompliant balloons produced high straightening forces, with short balloons making high stent conformability to the vessel wall in angulated lesions [6]. Since non-compliant balloons were often used for postdilatation after SES implantation in 106 lesions (46.7%) in this study, there is a possibility that this procedure reduced neointimal proliferation in angulated lesions.…”

Section: Discussionmentioning

confidence: 63%

The impact of angulated lesions on angiographic late loss in patients with drug-eluting stent implantation

Fukuda

Shirai

Miura

et al. 2009

Journal of Cardiology

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Angulated lesion was classified in moderate risk lesion subset in PTCA guidelines 2000, because angulated lesion has been associated with abrupt closure or myocardial injury. We compared angiographic late loss at 6-9 months in bending lesions to that in non-bending lesion. This study included 227 lesions (de nowo) who were implanted Cypher Sirolimus-eluting stent (SES). There were 52 bending lesions (22.9%) and 175 non-bending lesions (77.1%). There were no significant differences in age and complicated disease between the two groups except the higher prevalence of prior cerebral infarction in the bending lesion group. There were more eccentric lesions in the bending group than in the non-bending group (43.7% vs. 63.5%, p=0.01). Follow-up MLD (in stent) was not significantly different between the two groups (p=NS) and the angiographic restenosis rate was 23.6% in bending lesions and 17.8% in non-bending lesions (p=NS). In-stent and in-segment late loss were similar between the two groups (0.09+/-0.58 vs. 0.18+/-0.64, p=NS, 0.06+/-0.50 vs. 0.09+/-0.65, p=NS). No stent fracture was observed by angiography and IVUS in this study. Follow-up MLD (in stent) was not significantly different between the two groups (p=NS) and the angiographic restenosis rate was 23.6% in bending lesions and 17.8% in non-bending lesions (p=NS). Lesion bending is not associated with long-term angiographic late loss after DES implantation. DES may reduce clinical events in patients with bending lesion.

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Section: Discussionmentioning

confidence: 63%

The impact of angulated lesions on angiographic late loss in patients with drug-eluting stent implantation

Fukuda

Shirai

Miura

et al. 2009

Journal of Cardiology

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“…A study on the difference in the pressure exerted by 20 and 40 mm coronary angioplasty balloons reported a lower pressure for the longer balloon. 10 This study showed, the effective balloon length was adjusted to 7 mm for all SCBs and 10 mm for all CBs, except for Scepter XC, for which the length was set to 11 mm. However, the pressure exerted by Scepter XC was not lower than that of other SCBs, suggesting that the effective length had no particular effect.…”

Section: Discussionmentioning

confidence: 99%

“…When the balloon is inflated in a curved vessel, a straightening force is applied to the vessel wall, causing the pressure on the vessel wall to be higher than in a linear vessel. 10 In the treatment of coronary angioplasty, vessel angle is considered a predictor of procedural success; if the angle >90°, there is an increased risk of vessel dissection or occlusion. 12 In the present study, the pressure exerted after 1 mm balloon herniation was higher in the angulated model than in the straight model.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the differences in pressure applied to the vessel wall by different types of balloon remodeling microcatheters in an experimental model

et al. 2021

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Background We examined compliance differences among balloon remodeling microcatheters, which have not been established previously. Methods Straight and 120° angulated vascular models were created in a 3 mm diameter tube with 3 mm hole (vascular model A), a tube with a 4 mm hole (vascular model B), and a 4 mm diameter tube (vascular model C). We compared the pressure exerted when each balloon was herniated 1 or 2 mm between three compliant balloons (SHOURYU SR, TransForm C, and Scepter C) and four super-compliant balloons (HyperForm, SHOURYU HR, TransForm SC, and Scepter XC). Results In vascular model A, there was a significant difference in the pressure exerted by compliant balloons and super-compliant balloons in both the straight and angulated models. In the straight model (1 and 2 mm), the lowest pressure was exerted by HyperForm (super-compliant balloons group) and SHOURYU SR (compliant balloons group). The lowest pressure was exerted in the angulated model by HyperForm (super-compliant balloons group) and Scepter C (compliant balloons group). The Scepter balloon exerted higher pressure in the straight model than other balloon remodeling microcatheters but less in the angulated model. In vascular model B, the pressure decreased in all balloons compared with model A. In vascular model C, the pressure increased in all balloons compared with model A. Conclusions Pressure differed across balloon remodeling microcatheters. In addition, vessel shape and diameter, and hole size, affected the results. Our findings can help select balloon remodeling microcatheters.

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Werner¹

2002

Interventionelle Gefäßtherapie

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PTCA in angulated segments: Effects of balloon material, balloon length, and inflation sequence on straightening forces in an in vitro model

Cited by 5 publications

References 11 publications

The impact of angulated lesions on angiographic late loss in patients with drug-eluting stent implantation

The impact of angulated lesions on angiographic late loss in patients with drug-eluting stent implantation

Evaluation of the differences in pressure applied to the vessel wall by different types of balloon remodeling microcatheters in an experimental model

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