The autoperfusion balloon angioplasty catheter limits myocardial ischemia and necrosis during prolonged balloon inflation.
A new balloon angioplasty catheter with multiple proximal and distal side holes has previously been shown to allow significant protection from ischemia during a 3 min balloon inflation in a coronary artery. Because of the potential benefits of very long periods of inflation, 21 anesthetized thoracotomized dogs were randomized to left circumflex coronary artery occlusion with either a standard or an autoperfusion balloon catheter for 90 min. Nine dogs sustained ventricular fibrillation before completing the study, eight after standard balloon inflation and one after autoperfusion balloon inflation (p = 0.04). ST segment elevation was 0.45 +/- 0.13 mV after 15 min of standard balloon inflation versus -0.03 +/- 0.03 mV after autoperfusion balloon inflation (p less than 0.001). Regional myocardial blood flow was 0.02 +/- 0.01 ml/min per g after 30 min of standard balloon inflation compared with 0.78 +/- 0.23 ml/min per g in the group subjected to autoperfusion balloon inflation (p = 0.01). The area of necrosis/area at risk in the standard catheter group was 40.4 +/- 19.3% versus 1.2 +/- 1.2% for the autoperfusion catheter group (p = 0.01). Thus, the autoperfusion catheter preserves blood flow and limits myocardial ischemia and necrosis despite 90 min of balloon inflation.
Campbell
C A
CA
Division of Cardiology, Harper Hospital, Detroit, Michigan.
Rezkalla
S
S
Kloner
R A
RA
Turi
Z G
ZG
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000818:Animals; D003326:Coronary Circulation; D003327:Coronary Disease / Q000517:prevention & control*; D003331:Coronary Vessels / Q000502:physiology; D004285:Dogs; D004562:Electrocardiography; D005260:Female; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D013997:Time Factors