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Effect of routine postdilatation on final coronary blood flow in primary percutaneous coronary intervention patients without angiographic stent expansion problems
  1. Korhan Soylu1,
  2. Ali Ekber Ataş2,
  3. Mustafa Yenerçağ3,
  4. Murat Akçay1,
  5. Onur Şeker1,
  6. Gökhan Aksan4,
  7. Okan Gülel1,
  8. Mahmut Şahin1
  1. 1 Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
  2. 2 Department of Cardiology, Samsun Medical Park Private Hospital, Samsun, Turkey
  3. 3 Department of Cardiology, Samsung Training and Research Hospital, Samsun, Turkey
  4. 4 Department of Cardiology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
  1. Correspondence to MD Korhan Soylu, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey; korhansoylu{at}yahoo.com

Abstract

Inadequate expansion of coronary stents is associated with stent thrombosis in early stage and with stent restenosis in later stages. Postdilatation (postD) performed using non-compliant balloons improves stent expansion. However, use of this ballooning strategy in primary percutaneous coronary intervention (PPCI) has not been evaluated adequately. Patients who presented with ST segment elevation myocardial infarction (STEMI) and underwent PPCI were included in the present study. Patients were randomized into two groups as those for whom postD was performed (n=62) and those for whom postD was not performed (n=62). Coronary blood flow was evaluated using the thrombolysis in myocardial infarction (TIMI) flow and TIMI frame count (TFC). Total of 124 patients with STEMI were included in the study. There was no difference with respect to baseline TIMI flow, culprit coronary artery and MI localization. However, slow-reflow rate (14.5% vs 35.5%, p=0.007) and final corrected TFC (28.9±16.9 vs 37.0±23.1, p=0.028) were significantly higher in the postD group. Multivariate regression analysis showed postD as an independent variable for slow reflow (OR 11.566, 95% CI 1.633 to 81.908, p=0.014). In our study, routine postD during PPCI was found to be associated with an increased risk of slow reflow in patients without angiographic stent expansion problems.

  • coronary artery disease
  • myocardial infarction

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Footnotes

  • Contributors KS, AEA and MY were involved in the design and writing. MA and OS were responsible for data collection. GA was involved in the data calculation. GA and OG were involved in the writing and editing of the article. MŞ was also involved in the editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Our manuscript was approved by the local ethics committee of Ondokuz Mayis University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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