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

ABSTRACT

BACKGROUND AND OBJECTIVES: To reduce the subacute stent thrombosis, the use of high pressure final balloon dilatations and confirmation of adequate stent expansion by intravascular ultrasound has been recommended. The purpose of this study is to compare incidence of stent thrombosis and major cardiac events (MACE) between high and moderate pressure balloon technique without using intravascular ultrasound (IVUS) guidance. MATERIALS AND METHODS: We prospectively studied 147 patients (110 males & 37 females, mean;56.9+/-9.9 years, 154 lesions) who were deployed intracoronary stents with the use of conventional technique except IVUS guidance. According to inflation pressure, patients were divided into two groups; G1 (moderate pressure group, maximum inflation balloon pressure or =14ATM, 77 lesions). We investigated the incidence of stent thrombosis and MACE between two groups during the 10 month follow up examination. RESULTS: 1) The mean inflation presure is different between two groups by definition (G1:G2 10.2+/-1.8; 15.2+/-1.3 ATM p<0.001). 2) The stenotic lesion lengths of the group of patients treated with the moderate pressure techique were longer than those treated under the high pressure technique (G1:G2 19.8+/-7.1 mm; 16.3+/-4.1 mm p=0.002). 3) There were no significant differences between the moderate pressure group and the high pressure group during the 10 month follow-up examination in terms of MACE[early event (0-14D)-subacute thrombosis G1:G2 0:0 death G1; G2 1:1/late events (15D - 10M)-repeat revascularization:G1; G2 8; 7, CABG G1; G2 1; 0, Q.M.I G1; G2 1; 0]. CONCLUSION: Onselectedpatients,itispossibletoconsidermoderatepressure technique as an other option for coronary stenting.