INTRACORONARY STENT IMPLANTATION USING A SINGLE HIGH-PRESSURE PERFUSION BALLOON CATHETER

Currently, the recommended strategy for Palmaz-Schatz intracoronary st ent implantation is to use two balloons: an undersized balloon for pre dilation to facilitate a channel for the stent and a high pressure bal loon for postdilation to obtain good apposition of the struts into the vessel wall. We reported our experience using the perfusion balloon a s the initial balloon to dilate intracoronary lesions and demonstrated a reduction in the total number of balloons used per angioplasty proc edure, The objective of this study was to examine whether a single bal loon could effectively be used for stent implantation. The study popul ation included 95 patients who underwent elective intracoronary stent placement to 100 lesions using 110 Palmaz-Schatz stents by nine indivi dual operators, Lesions were predilated with an ACS RX LIFESTREAM ball oon at a low pressure of 4-6 atm (mean 5.7 +/- 2.6), After stent deplo yment, the same balloon was used at a high pressure (mean 16.2 +/- 1.2 ). Mean balloon size, which was chosen as the stent size, was 3.4 +/- 0.4 mm, Comparison of this strategy with the recommended strategy of 6 8 consecutive elective stent deployments at a single center during the same time was performed. Stent implantation using a single balloon st rategy was angiographically successful in 99 of 100 (99.0%) lesions. T he single balloon strategy was associated with a balloon burst rate of 9.1%, The number of balloons used per stent deployment was 1.2 vs, 2. 4 using the recommended strategy (P < 0.0001). There was no evidence o f stent thrombosis, any MI, or target lesion revascularization during the procedure and hospitalization. One in-hospital death as a result o f nonhemorragic stroke was documented in the treated group. We conclud ed that using a single high pressure perfusion balloon for pre and pos tdilation in patients undergoing elective stent placement is safe and reduces the number of balloons used per procedure. (C) 1997 Wiley-Liss , Inc.