van Beek K A J, Timmermans M J C, Derks L, Cheng J M, Kraaijeveld A O, Arkenbout E K, Schotborgh C E, Brouwer J, Claessen B E, Lipsic E, Polad J, van Nunen L X, Sjauw K, van Veghel D, Tonino P A, Teeuwen K
Heart Centre, Catharina Hospital, Eindhoven, The Netherlands.
PCI Registration, Netherlands Heart Registration, Utrecht, The Netherlands.
Catheter Cardiovasc Interv. 2025 Mar;105(4):870-877. doi: 10.1002/ccd.31404. Epub 2025 Jan 8.
Post-dilatation after stenting with a non-compliant (NC) balloon can be used to improve overall percutaneous coronary intervention (PCI) result. Due to lack of evidence on the effect of post-dilatation on adverse clinical endpoints there is no consensus whether post-dilatation should be used routinely. The aim of the current study was to determine the contemporary practice of post-dilatation.
This study included patients from the Netherlands Heart Registration who underwent PCI between the 4th quarter of 2020 and the 3rd quarter of 2021. The primary endpoint was the rate of post-dilatation with a NC balloon. Secondary endpoints included differences in baseline and procedural characteristics of patients that received post-dilatation and patients that did not receive post-dilatation.
Out of 12,960 patients from 11 hospitals, 49.9% underwent post-dilatation. There was a variety in post-dilatation between hospitals ranging from 29.3% to 82.7% and among operators ranging from 15.9% to 90.5%. Post-dilatation was used less frequent in patients presenting with ST-elevation myocardial infarction or out of hospital cardiac arrest. Multivessel and left main PCI, long stent length and use of intracoronary imaging and calcium modification were associated with increased use of post-dilatation. When imaging was used, the percentage of post-dilatation was 79.4%.
In the Netherlands, stent optimization with post-dilatation using NC balloon is performed in only half of the patients undergoing PCI, with variations in frequency across centres and operators. Post-dilatation is more often used in cases of complex PCI and when intracoronary imaging or calcium modification techniques are used.
使用非顺应性（NC）球囊进行支架置入术后的后扩张可用于改善整体经皮冠状动脉介入治疗（PCI）效果。由于缺乏关于后扩张对不良临床终点影响的证据，对于是否应常规使用后扩张尚无共识。本研究的目的是确定后扩张的当代实践情况。
本研究纳入了来自荷兰心脏注册中心在2020年第四季度至2021年第三季度期间接受PCI的患者。主要终点是使用NC球囊进行后扩张的比例。次要终点包括接受后扩张和未接受后扩张患者的基线和手术特征差异。
在来自11家医院的12960例患者中，49.9%接受了后扩张。各医院之间后扩张的比例有所不同，范围从29.3%至82.7%，各操作者之间的比例范围从15.9%至90.5%。ST段抬高型心肌梗死或院外心脏骤停患者使用后扩张的频率较低。多支血管和左主干PCI、较长的支架长度以及冠状动脉内成像和钙化修饰的使用与后扩张的使用增加相关。当使用成像时，后扩张的比例为79.4%。
在荷兰，仅一半接受PCI的患者使用NC球囊进行后扩张以优化支架，各中心和操作者之间的频率存在差异。后扩张在复杂PCI病例以及使用冠状动脉内成像或钙化修饰技术时更常使用。
