Cargando…

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

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 recom...

Descripción completa

Detalles Bibliográficos
Autores principales: Sorrentino, Sabato, De Rosa, Salvatore, Ambrosio, Giuseppe, Mongiardo, Annalisa, Spaccarotella, Carmen, Polimeni, Alberto, Sabatino, Jolanda, Torella, Daniele, Caiazzo, Gianluca, Indolfi, Ciro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676860/
https://www.ncbi.nlm.nih.gov/pubmed/26654975
http://dx.doi.org/10.1186/s12872-015-0163-5
_version_ 1782405244513157120
author Sorrentino, Sabato
De Rosa, Salvatore
Ambrosio, Giuseppe
Mongiardo, Annalisa
Spaccarotella, Carmen
Polimeni, Alberto
Sabatino, Jolanda
Torella, Daniele
Caiazzo, Gianluca
Indolfi, Ciro
author_facet Sorrentino, Sabato
De Rosa, Salvatore
Ambrosio, Giuseppe
Mongiardo, Annalisa
Spaccarotella, Carmen
Polimeni, Alberto
Sabatino, Jolanda
Torella, Daniele
Caiazzo, Gianluca
Indolfi, Ciro
author_sort Sorrentino, Sabato
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-015-0163-5) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4676860
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-46768602015-12-13 The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment Sorrentino, Sabato De Rosa, Salvatore Ambrosio, Giuseppe Mongiardo, Annalisa Spaccarotella, Carmen Polimeni, Alberto Sabatino, Jolanda Torella, Daniele Caiazzo, Gianluca Indolfi, Ciro BMC Cardiovasc Disord Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-015-0163-5) contains supplementary material, which is available to authorized users. BioMed Central 2015-12-11 /pmc/articles/PMC4676860/ /pubmed/26654975 http://dx.doi.org/10.1186/s12872-015-0163-5 Text en © Sorrentino et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sorrentino, Sabato
De Rosa, Salvatore
Ambrosio, Giuseppe
Mongiardo, Annalisa
Spaccarotella, Carmen
Polimeni, Alberto
Sabatino, Jolanda
Torella, Daniele
Caiazzo, Gianluca
Indolfi, Ciro
The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title_full The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title_fullStr The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title_full_unstemmed The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title_short The duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
title_sort duration of balloon inflation affects the luminal diameter of coronary segments after bioresorbable vascular scaffolds deployment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676860/
https://www.ncbi.nlm.nih.gov/pubmed/26654975
http://dx.doi.org/10.1186/s12872-015-0163-5
work_keys_str_mv AT sorrentinosabato thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT derosasalvatore thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT ambrosiogiuseppe thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT mongiardoannalisa thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT spaccarotellacarmen thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT polimenialberto thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT sabatinojolanda thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT torelladaniele thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT caiazzogianluca thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT indolficiro thedurationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT sorrentinosabato durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT derosasalvatore durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT ambrosiogiuseppe durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT mongiardoannalisa durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT spaccarotellacarmen durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT polimenialberto durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT sabatinojolanda durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT torelladaniele durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT caiazzogianluca durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment
AT indolficiro durationofballooninflationaffectstheluminaldiameterofcoronarysegmentsafterbioresorbablevascularscaffoldsdeployment