TY - JOUR
T1 - A pilot study of perfusion balloon predilatation in conjunction with intracoronary nicorandil administration for acute coronary syndrome
AU - Yoshinaga, Masataka
AU - Muramatsu, Takashi
AU - Ishikawa, Masato
AU - Toriya, Takuo
AU - Uwatoko, Takashi
AU - Matsuwaki, Yuji
AU - Ukai, Yuko
AU - Kobayashi, Yohei
AU - Ito, Katsuyoshi
AU - Ota, Hideaki
AU - Izawa, Hideo
N1 - Publisher Copyright:
© The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics 2024.
PY - 2025/1
Y1 - 2025/1
N2 - Slow-flow or no-reflow phenomenon is a common procedural complication during percutaneous coronary intervention (PCI). Given the presence of fragile plaque or thrombotic materials, we hypothesized that long-time predilatation using a perfusion balloon in conjunction with intracoronary nicorandil administration reduces the risk of slow-flow or no-reflow in patients presenting with acute coronary syndrome (ACS). Subjects were patients presenting with ACS who underwent PCI between April 2020 and April 2022. We retrospectively investigated the incidence of slow-flow or no-reflow during the procedure as well as in-hospital outcomes in comparison between the cases undergoing 3-min predilatation using a perfusion balloon in conjunction with intracoronary nicorandil administration followed by DES implantation (PB group) and those with direct stenting (DS group). Among 439 ACS patients, 36 patients in the PB group and 51 patients in the DS group were examined. Mean age was 70 years and 78.2% was male. Distal protection devices were more frequently used in the DS group than in the PB group (31.3% vs. 11.1%, p = 0.02). The incidence rate of slow-flow or no-reflow was significantly lower in the PB group than in the DS group (2.8% vs. 23.5%; p < 0.01). Six cases (11.7%) in the DS group required intra-aortic balloon pumping (IABP), while none in the PB group required (p < 0.01). In-hospital clinical outcomes did not differ between the two groups. Prolonged perfusion balloon predilatation in conjunction with intracoronary nicorandil administration was safe and feasible. This novel strategy could be an attractive alternative to conventional direct stenting for ACS patients.
AB - Slow-flow or no-reflow phenomenon is a common procedural complication during percutaneous coronary intervention (PCI). Given the presence of fragile plaque or thrombotic materials, we hypothesized that long-time predilatation using a perfusion balloon in conjunction with intracoronary nicorandil administration reduces the risk of slow-flow or no-reflow in patients presenting with acute coronary syndrome (ACS). Subjects were patients presenting with ACS who underwent PCI between April 2020 and April 2022. We retrospectively investigated the incidence of slow-flow or no-reflow during the procedure as well as in-hospital outcomes in comparison between the cases undergoing 3-min predilatation using a perfusion balloon in conjunction with intracoronary nicorandil administration followed by DES implantation (PB group) and those with direct stenting (DS group). Among 439 ACS patients, 36 patients in the PB group and 51 patients in the DS group were examined. Mean age was 70 years and 78.2% was male. Distal protection devices were more frequently used in the DS group than in the PB group (31.3% vs. 11.1%, p = 0.02). The incidence rate of slow-flow or no-reflow was significantly lower in the PB group than in the DS group (2.8% vs. 23.5%; p < 0.01). Six cases (11.7%) in the DS group required intra-aortic balloon pumping (IABP), while none in the PB group required (p < 0.01). In-hospital clinical outcomes did not differ between the two groups. Prolonged perfusion balloon predilatation in conjunction with intracoronary nicorandil administration was safe and feasible. This novel strategy could be an attractive alternative to conventional direct stenting for ACS patients.
KW - Acute coronary syndrome
KW - Complication
KW - Percutaneous coronary intervention
KW - Perfusion balloon
KW - Slow-flow
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UR - http://www.scopus.com/inward/citedby.url?scp=85201210995&partnerID=8YFLogxK
U2 - 10.1007/s12928-024-01034-0
DO - 10.1007/s12928-024-01034-0
M3 - Article
C2 - 39136888
AN - SCOPUS:85201210995
SN - 1868-4300
VL - 40
SP - 45
EP - 56
JO - Cardiovascular Intervention and Therapeutics
JF - Cardiovascular Intervention and Therapeutics
IS - 1
M1 - e025728
ER -