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| Name | Class |
|---|---|
| Anglia Ruskin University | OTHER |
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This study aims to assess the impact of NC balloon post-dilatation on coronary microcirculation in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).
Suboptimal stent deployment can lead to future stent failure. Thus, optimising stent deployment with non-compliant balloons (NC balloon) post dilatation (PD) at high pressures is an established strategy. In the context of ST segment elevation myocardial infarction (STEMI), PD has been correlated anecdotally with the no reflow phenomenon.
This study aims to determine the impact of stent post-dilation (PD) with NC balloons at high pressures on coronary microcirculation during PPCI by measuring the index of microcirculatory resistance (IMR) pre and post stent post-dilatation. Pre and post PD, an optical coherence tomography (OCT) study will be performed to assess stent deployment and identify parameters that predict the changes in IMR.
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| Measure | Description | Time Frame |
|---|---|---|
| Delta index of microcirculatory resistance (dIMR) | Delta index of microcirculatory resistance (dIMR) [dΙΜΡ = IMR post post-dilation (post IMR) - IMR pre post-dilation (pre IMR)] | index procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Minimum stent area (MSA) | Pre and post dilatation minimum stent area | index procedure |
| Stent expansion | Pre and post dilatation stent expansion; defined as the minimum stent area divided by the average of proximal and distal reference lumen areas x 100 |
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Inclusion Criteria
Exclusion Criteria
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STEMI patients undergoing PPCI
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| Name | Affiliation | Role |
|---|---|---|
| John R Davies, MD PhD | Mid and South Essex NHS Foundation Trust | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Essex Cardiothoracic Centre | Basildon | Essex | SS16 5NL | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32329200 | Derived | Karamasis GV, Kalogeropoulos AS, Gamma RA, Clesham GJ, Marco V, Tang KH, Jagathesan R, Sayer JW, Robinson NM, Kabir A, Aggarwal RK, Kelly PA, Prati F, Keeble TR, Davies JR. Effects of stent postdilatation during primary PCI for STEMI: Insights from coronary physiology and optical coherence tomography. Catheter Cardiovasc Interv. 2021 Jun 1;97(7):1309-1317. doi: 10.1002/ccd.28932. Epub 2020 Apr 23. |
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| ID | Term |
|---|---|
| D000072657 | ST Elevation Myocardial Infarction |
| ID | Term |
|---|---|
| D009203 | Myocardial Infarction |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| index procedure |
| Stent mal-apposition | Stent mal-apposition pre and post dilatation; defined as a distance between the strut's luminal edge and luminal vessel wall of greater >200 μm for a length >600 μm (appreciable in >3 contiguous frames at a pull-back speed of 20 mm/sec | index procedure |
| Intra-stent plaque protrusion and thrombus | Pre and post dilatation intra-stent plaque protrusion and thrombus; defined as a mass attached to the luminal surface or floating within the lumen at least 200 μm beyond the luminal edge of a strut | index procedure |
| Stent edge dissections | Edge dissections pre and post dilatation, further defined as major and minor [major dissections defined as the ones with a dissection flap width greater or equal to 200 μm)](streamdown:incomplete-link) | index procedure |
| D014652 |
| Vascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |