Routine coronary angioplasty with autoperfusion balloon catheter: Can prolonged inflations reduce myocardial ischemia and preserve myocardial function?

Percutaneous transluminal coronary angioplasty (PTCA) is an established technique in the management of patients with angina pectoris or acute myocardial infarction. One of the major problems related to PTCA is myocardial ischemia following balloon catheter occlusion of the coronary artery. A new device utilized in an attempt to counteract myocardial ischemia is the perfusion balloon catheter which allows passive transmission of pulsatile blood flow to the distal myocardial bed. Our purpose was to compare immediate results following traditional PTCA and autoperfusion balloon PTCA in two groups randomly assigned to receive one of the two treatments (total patients n. = 158). The results show that coronary angioplasty was successfully performed in 98.87% of patients treated with autoperfusion PTCA and in 97.10% of those treated with conventional PTCA. In the autoperfusion PTCA group we observed a lower incidence (statistically significant) of ST elevation and of minor complications. We conclude that autoperfusion balloon catheter angioplasty may be recommended for its immediate success rate with good patient tolerance and lower incidence of in-hospital complications.