Prevention of no-reflow phenomenon in culprit lesions involving a large side branch.
No-reflow/slow-flow phenomenon (NF) is a poor prognostic factor in patients undergoing percutaneous coronary intervention. Distal protection devices (DPDs) prevent myocardial injury due to microembolic debris. When the target lesion involves a large side branch, DPDs can only protect the main vessel but not the side branch. In the present report, we describe the use of a two-step deflation in kissing-balloon technique for preventing NF in 4 patients (M/F = 4/0, 65 ± 6 years) in which the culprit lesions with NF risk involved a bifurcation. The procedures were uneventful and the 4 patients were discharged ≤24 h without ECG change and elevation of serum level of creatine kinase. The sequential deflation of kissing-balloon technique may constitute a possible solution for the NF related with the side branch on bifurcation lesions.
Centre for Inherited Cardiovascular Diseases, Transplant Research Area, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy, kodama-tk@umin.ac.jp.
Takahide
T
Kodama
Akitsugu
A
Oida
Makoto
M
Kondo
Takeshi
T
Kondo
Eloisa
E
Arbustini
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000601:surgery*; D057505:Embolic Protection Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000379:methods*