Abstract

Background: Intracoronary thrombus followed by a rupture of unstable vulnerable plaque is a well-known cause of acute coronary syndrome (ACS). The no reflow/slow flow phenomenon is sometimes observed during a primary percutaneous coronary intervention (PCI) against ACS. It has already been shown that long inflation using a perfusion balloon (PB) is useful to remediate a coronary perforation. Thus, we investigated the usefulness of a PB for treating ACS. Methods: This study was a retrospective, single-center, observational study. One hundred-seven patients with ACS underwent PCI from January 2015 to December 2017 in our hospital. Fifty patients were treated by PB directly (PB group) and the remaining 57 patients were treated by another conventional balloon (C group). We used the Ryuseio balloon (Kaneka, Japan) as a PB. The clinical outcome was the incidence of the no reflow or slow flow phenomenon, the incidence of using IABP. Results: One patient in the PB group demonstrated slow flow phenomenon temporarily, and the coronary flow was quickly restored by thromboaspiration. In contrast, nine patients in the C group had occurrences of no reflow/slow flow phenomenon. Although all patients in the C group required stenting, some patients (24%) of the PB group did not require stenting. Conclusion: We found that the use of PB had a favorable effect on the treatment of ACS. Some patients completed PCI without a need for stenting.

Highlights

  • Fifty patients were treated by perfusion balloon (PB) directly (PB group) and the remaining 57 patients were treated by another conventional balloon (C group)

  • The purpose of this study is to investigate the usefulness of a Perfusion balloon (PB) in acute coronary syndrome (ACS) patients with vulnerable plaque

  • Seventeen patients were excluded from the study: 4patients who were treated with direct stenting, and 13patients who had been medicated with a statin and the level of low-density lipoprotein cholesterol (LDL-C) was less than 100 mg/dL according the blood test

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Summary

Introduction

It has been shown that there is an association between elevated LDL-C and vulnerable plaque in the coronary arteries [4] [5]. Intracoronary thrombus followed by a rupture of unstable vulnerable plaque is a well-known cause of acute coronary syndrome (ACS). The no reflow/slow flow phenomenon is sometimes observed during a primary percutaneous coronary intervention (PCI) against ACS. Results: One patient in the PB group demonstrated slow flow phenomenon temporarily, and the coronary flow was quickly restored by thromboaspiration. Nine patients in the C group had occurrences of no reflow/slow flow phenomenon.

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