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

    Highlights

    • Calcific coronary lesions can be so resistant to prevent symmetric stent expansion;
    • Stent underxpansion increase the risk of ISR an ST and VLST;
    • The OPN twin-layer technology provides an highly non-compliant structure that allows the use of very high pressure inflations
    • High-pressure dilatation (>40 ATM) was able to achieve adequate stent expansion

    Abstract

    Background

    Calcific coronary lesions can be so resistant to prevent symmetric stent dilatation with high risk of ISR/thrombosis. The aim of the current study is to evaluate the safety and efficacy of super high-pressure dilatation (>30-to-45Atm) using a dedicated NC-balloon (OPN, SIS-Medical-AG, Winterthur-Switzerland).

    Methods

    We retrospectively evaluated 326 consecutive undilatable lesions in which conventional NC-balloons failed to achieve adequate post-dilatation luminal gain. After the failed attempt an OPN-balloon was inflated up to achieve a uniform balloon expansion (maximal dilatation pressure of 45–50 Atm). Lesions were divided into two groups according to the final inflation pressure: Group-I: lesion responsive to 30-40Atm and Group-2:>40 Atm. Angiographic success was defined as residual angiographic stenosis<30% assessed by visual estimation with TIMI3-flow. Procedural success was defined as the achievement of angiographic success without any MACE.

    Results

    Angiographic success was achieved in 97.5%, procedural success in 96.6%; 53% of the lesions were responsive to a slower inflation pressure (Group I) while in the remaining 47%, the optimal expansion required a pressure > 40ATM (Group II). In 3 patients coronary rupture occurred after balloon inflation and was successfully treated with stent implantation with a final TIMI3-flow. The OPN alone was able to achieve adequate expansion in >90%. 0.9% days MACE were reported.

    Conclusion

    The OPN-dedicated high-pressure balloon provides an effective and safe strategy for treatment of severe resistant coronary lesions.

    Author bio

    Cardiovascular Revascularization Medicine, 2019-12-01, Volume 20, Issue 12, Pages 1083-1087, Copyright © 2019 Elsevier Inc.

    Source:

    Read the full article on Science Direct: Clinical Experience with Very High-Pressure Dilatation for Resistant Coronary Lesions

This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Review our Privacy Policy for more details