Duration of balloon inflation for optimal stent deployment: Five Seconds Is Not Enough

2012 ◽  
Vol 81 (3) ◽  
pp. 446-453 ◽  
Author(s):  
Thomas Hovasse ◽  
Darren Mylotte ◽  
Philippe Garot ◽  
Neus Salvatella ◽  
Marie-Claude Morice ◽  
...  
Keyword(s):  
Balloon Inflation ◽  
Stent Deployment

Optimal Balloon Inflation Pressures for Stent Deployment: High Pressure is Always Good?

1998 ◽  
Vol 28 (8) ◽  
pp. 1272 ◽  
Author(s):  
Eun Mi Lee ◽  
Dong Joo Oh ◽  
Hyun Chul Kim ◽  
Byung Hoe Kim ◽  
Soo Mi Kim ◽  
...  
Keyword(s):  
High Pressure ◽  
Balloon Inflation ◽  
Stent Deployment

scholarly journals A Case of an Obstructive Intramural Haematoma during Percutaneous Coronary Intervention Successfully Treated with Intima Microfenestrations Utilising a Cutting Balloon Inflation Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Osama Alsanjari ◽  
Aung Myat ◽  
James Cockburn ◽  
Grigoris V. Karamasis ◽  
David Hildick-Smith ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Intervention ◽  
Intramural Haematoma ◽  
Balloon Inflation ◽  
Cutting Balloon ◽  
Stent Deployment ◽  
Stent Expansion ◽  
Percutaneous Coronary

During percutaneous coronary interventions (PCI), good lesion preparation with adequate balloon predilatation is a fundamental step before stent deployment in order to achieve optimal stent expansion and favourable long-term outcomes post PCI. During PCI, inadvertent vessel tearing can occur, resulting in coronary dissections and formation of intramural haematomas. The latter might be associated with compression of the vessel lumen and significant compromise of the coronary blood flow leading to myocardial ischaemia and infarction. Herein, we present a case of intramural haematoma that occurred after PCI of the left anterior descending artery resulting in occlusion of the vessel and the subsequent use of a cutting balloon inflation technique to resolve the haematoma and restore the normal coronary blood flow.

Proximal Stent Deployment without Contrast during Endovascular Aneurysm Repair: An Improved Technique

1996 ◽  
Vol 3 (4) ◽  
pp. 380-381 ◽  
Author(s):  
Jonathan R. Boyle ◽  
Matthew M. Thompson ◽  
Akhtar Nasim ◽  
Robert D. Sayers ◽  
Guy Fishwick ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Normal Saline ◽  
Early Recognition ◽  
Endovascular Aneurysm Repair ◽  
Balloon Inflation ◽  
Stent Deployment ◽  
Radiopaque Marker ◽  
Fluoroscopic Image ◽  
Improved Technique ◽  
Aneurysm Repair

Purpose: To describe a technique to enhance stent visibility on the fluoroscopic monitor during aortic endograft deployment. Technique: To assist in accurate positioning and deployment of the proximal stent in a Parodi-type aortic endograft, the stent is affixed to the balloon so that the radiopaque marker sits at the stent's distal end. When the device is in position and the sheath is retracted, the stent and the radiopaque balloon markers are clearly seen on the fluoroscopic image. Using normal saline only to inflate the balloon allows the stent to remain visible throughout deployment. Conclusions: The use of saline rather than contrast medium for balloon inflation provides continuous visualization of the stent during expansion, thus facilitating accurate deployment and early recognition of balloon migration within the stent.

scholarly journals Inflation Pressure in Side Branch during Modified Jailed Balloon Technique Does Not Affect Side Branch Outcomes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Tetsuya Nomura ◽  
Naotoshi Wada ◽  
Issei Ota ◽  
Satoshi Tasaka ◽  
Kenshi Ono ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Coronary Intervention ◽  
Side Branch ◽  
Plaque Burden ◽  
Lesion Length ◽  
Inflation Pressure ◽  
Balloon Inflation ◽  
Stent Deployment ◽  
Main Vessel ◽  
Balloon Technique

Objectives. This study aimed to investigate the optimal jailed balloon inflation in the side branch during the modified jailed balloon technique for bifurcated lesions. Background. The modified jailed balloon technique is one of the effective techniques to minimize the emergence of side branch (SB) compromise by preventing plaque or carina shifting during a single stent strategy in the main vessel with provisional SB treatment. However, there are no detailed studies on the method of optimal jailed balloon inflation. Methods. We analyzed 51 consecutive patients who underwent percutaneous coronary intervention (PCI) for bifurcated lesions with a modified jailed balloon technique between September 2018 and December 2020. These 51 patients were divided into two groups according to the magnitude of inflation pressure of the jailed balloon: a higher pressure (HP) group and lower pressure (LP) group. Results. No significant differences in procedural outcomes were observed between the two groups. The findings of SB compromise were relatively common with our procedure (30.0% in the HP group; 33.3% in the LP group). The patterns of SB compromise such as dissection or stenosis increase were observed at similar frequencies between them. In particular, SB dissection was noted in the SB lesion with some plaque burden, irrespective of the magnitude of the jailed balloon inflation pressure. Univariate analysis showed that calcification in the main vessel and SB lesion length was significantly associated with SB compromise. Finally, all PCI procedures were successfully completed without any provisional stent deployment in SB. Conclusions. We speculate that lesion characteristics rather than the PCI procedural factors may be critical determinants to cause SB compromise.

Optimal kissing balloon inflation after single-stent deployment in a coronary bifurcation model

2014 ◽  
Vol 10 (8) ◽  
pp. 934-941 ◽  
Author(s):  
Yoshinobu Murasato ◽  
Kiyotaka Iwasaki ◽  
Tadashi Yamamoto ◽  
Takanobu Yagi ◽  
Yutaka Hikichi ◽  
...  
Keyword(s):  
Coronary Bifurcation ◽  
Balloon Inflation ◽  
Stent Deployment

Markers of Hemostatic Activation in Affected Coronary Arteries during Angioplasty

1994 ◽  
Vol 72 (05) ◽  
pp. 672-675 ◽  
Author(s):  
Nicolas W Shammas ◽  
Michael J Cunningham ◽  
Richard M Pomearntz ◽  
Charles W Francis
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Venous Blood ◽  
Balloon Inflation ◽  
Blood Samples ◽  
Hemostatic System ◽  
Significant Difference ◽  
Hemostatic Markers ◽  
Artery Disease ◽  
High Doses

SummaryTo characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrino-peptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation ((3-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.

Predisposing Factors, Demographics, Angiographic Features, and the Possible Role of Inflammation in Coronary Perforations—A 10-year Single-center Experience

2011 ◽  
Vol 9 (2) ◽  
pp. 87 ◽  
Author(s):  
Preeti Chandra ◽  
Saurav Chatterjee ◽  
Nishant Koradia ◽  
Deepak Thekkoott ◽  
Bilal Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Predisposing Factors ◽  
Covered Stents ◽  
Optimal Management ◽  
Balloon Inflation ◽  
Catheterization Laboratory ◽  
Cell Counts

Background:Coronary perforation during percutaneous coronary intervention is a rare but dreaded complication. The risk factors, optimal management, and outcome remain obscure.Objectives:To determine the predisposing factors, optimal management, and preventive strategies. We retrospectively looked at coronary perforations at our catheterization laboratory over the last 10 years. We reviewed patient charts and reports. Two independent operators, in a blinded approach, reviewed all procedural cineangiograms. Data were analyzed by simple statistical methodology.Results:Nine patients were treated conservatively and six patients were treated with prolonged balloon inflation. Six patients were treated with polytetrafluoroethylene (PTFE)-covered stents. One patient required emergency coronary artery bypass graft. No deaths were reported. Subjects with perforations also had a significantly higher total white blood cell count (means 12,134 versus 6,155, 95 % confidence interval [CI], p< 0.0001, n=22), total absolute neutrophil count (means 74.2 % versus 57.1 %, 95 % CI, p<0.0001, n=22), and neutrophil:lymphocyte ratio (means 3.65 versus 1.50, 95% CI, p<0.0001, n=22).Conclusions:Coronary perforations are rare but potentially fatal events. Hypertension, small vessel diameter, high balloon:artery ratio, use of hydrophilic wires, and presence of myocardial bridging appear to be possible risk factors. Most perforations can be treated conservatively or with prolonged balloon inflation using perfusion balloons. Use of PTFE-covered stents could be a life-saving measure in cases of large perforations. Subjects with perforations also had greater systemic inflammation as indicated by elevated white cell counts.

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