Clinical Characteristics of Patents who Developed Slow Flow/ no-reflow After Post-dilatation with Non-compliant Balloon during Primary Percutaneous Coronary Intervention

Authors

  • Chander Parkash National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Vashu Mal National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Muhammad Asim Shaikh National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Dileep Kumar National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Rameez Ahmed National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Sara Masood National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jehanghir Ali Shah National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Bashir Ahmed National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Naveedullah Khan National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jawaid Akbar Sial National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v56i1.2413

Abstract

Objectives: Post-dilatation with non-compliant (NC) balloons is a commonly used strategy to improve inadequate stent expansion but this strategy carries an increased risk of slow flow/no-reflow (SF/NR) due to distal embolization. Therefore, our objective was to evaluate the demographic, clinical, angiographic, and procedure characteristics among patients undergoing primary percutaneous coronary intervention (PCI) who developed slow flow/no-reflow (SF/NR) after post-dilatation with non-compliant (NC) balloons.

Methodology: In this cross-sectional observational study, we included consecutive patients with SF/NR after post-dilatation using NC balloon post stent deployment during primary PCI. The demographic, clinical, angiographic, and procedure characteristics were evaluated.

Results: In the sample of 107 patients, male were 77.6% (83) and mean age was 56.94 ± 10.47 years. The median chest pain to ER (emergency room) arrival time was 292 [180-394] minutes. A majority of the patients (66.4%) had multi-vessel disease. Mean length NC balloon was 10.57±1.98 mm and diameter was 3.5±0.26 mm. The mean number of inflation were 3.62±1.08, at mean maximal pressure of 20.43±2.49 mmHg, proximal edge pressure of 19.25±2.74 mmHg, and distal edge pressure of 14.64±2.01 mmHg. A total of 5.6% (6) patients developed adverse events and final TIMI (thrombolysis in myocardial infarction) III flow was achieved in 89.7% (96) of the patients.

Conclusion: SF/NR after post-dilatation during primary PCI is associated with a significant rate of adverse events and sub-optimal (<III) final TIMI flow. The detrimental effects of high pressure, short length, and increased number of inflations on post NC SF/NR need further investigations.

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Published

2023-04-01

How to Cite

1.
Parkash C, Mal V, Shaikh MA, Kumar D, Ahmed R, Masood S, Shah JA, Ahmed B, Khan N, Sial JA. Clinical Characteristics of Patents who Developed Slow Flow/ no-reflow After Post-dilatation with Non-compliant Balloon during Primary Percutaneous Coronary Intervention. Pak Heart J [Internet]. 2023Apr.1 [cited 2024Mar.3];56(1):110-4. Available from: https://pakheartjournal.com/index.php/pk/article/view/2413

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Original Article