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球囊扩张持续时间会影响生物可吸收血管支架置入术后冠状动脉节段的管腔直径。

The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment.

作者信息

Sorrentino Sabato, De Rosa Salvatore, Ambrosio Giuseppe, Mongiardo Annalisa, Spaccarotella Carmen, Polimeni Alberto, Sabatino Jolanda, Torella Daniele, Caiazzo Gianluca, Indolfi Ciro

机构信息

Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.

URT-CNR, Magna Graecia University, Catanzaro, Italy.

出版信息

BMC Cardiovasc Disord. 2015 Dec 11;15:169. doi: 10.1186/s12872-015-0163-5.

Abstract

BACKGROUND

Adequate expansion is critical to achieve optimal Bioresorbable Vascular Scaffolds (BVS) apposition to the vessel wall. However, compared to metallic stents, BVS present different mechanical properties. Hence, slow deployment and maintenance of balloon inflation for at least 30" is recommended for BVS implantation. However, since no evidences are available demonstrating the superiority of a longer balloon dilatation time, the implantation technique is highly variable among different centers.

METHODS

A total of 24 BVS-treated lesions were included in the present analysis. After BVS deployment at 12 atmosphere (ATM) the balloon was rapidly deflated and scaffold expansion was documented with an angiogram. The same balloon was then inflated again and kept at 12 ATM for 30". Finally, a further angiogram was obtained to evaluate BVS expansion. Quantitative coronary angiography (QCA) was performed at each step.

RESULTS

A significant increase of minimal luminal diameter (MLD)-to-reference scaffold diameter (RSD) ratio (MLD to RSD Ration, MR-Ratio) from 0.70 ± 0.10 after initial stent deployment to 0.79 ± 0.10 after the 30"-long balloon dilation was observed (p < 0.001). Of note, this result was consistent across all sub-segments, as well as across almost all lesion subgroups. A substantial reduction in the prevalence of residual stenosis from 29 % to 17 % was registered after the 30"-long dilation.

CONCLUSIONS

Our results strongly support the maintenance of balloon inflation for at least 30" during BVS deployment to achieve optimal scaffold expansion and minimize the occurrence of residual stenosis.

摘要

背景

充分扩张对于生物可吸收血管支架(BVS)与血管壁实现最佳贴合至关重要。然而,与金属支架相比,BVS具有不同的机械性能。因此,建议在植入BVS时缓慢展开并将球囊充气维持至少30秒。然而,由于尚无证据表明更长的球囊扩张时间具有优越性,不同中心的植入技术差异很大。

方法

本分析共纳入24个接受BVS治疗的病变。在12个大气压(ATM)下展开BVS后,迅速放气球囊,并通过血管造影记录支架扩张情况。然后将同一个球囊再次充气并维持在12 ATM 30秒。最后,再次进行血管造影以评估BVS扩张情况。每一步均进行定量冠状动脉造影(QCA)。

结果

观察到最小管腔直径(MLD)与参考支架直径(RSD)之比(MLD与RSD比值,MR比值)从初始支架展开后的0.70±0.10显著增加至30秒长球囊扩张后的0.79±0.10(p<0.001)。值得注意的是,这一结果在所有亚段以及几乎所有病变亚组中均一致。30秒长扩张后,残余狭窄的发生率从29%大幅降至17%。

结论

我们的结果有力支持在BVS展开过程中将球囊充气维持至少30秒,以实现最佳支架扩张并将残余狭窄的发生降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/257a/4676860/8445cd325a73/12872_2015_163_Fig1_HTML.jpg

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