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Young Joon Hong, MD, PhD,
Myung Ho Jeong, MD, PhD, FACC*
In our study (1), we did not perform additional ballooning for the plaque prolapse (PP) lesions routinely. Instead, we performed additional ballooning when we observed stent underexpansion after stent implantation. Among a total of 85 PP lesions, additional ballooning was performed in 30 lesions. The PP areas did not differ significantly after additional ballooning from those immediately after stent implantation (maximum PP areas, 0.8 ± 0.6 mm2 vs. 0.7 ± 0.5 mm2, p = 0.5, and PP volumes, 2.6 ± 2.0 mm3 vs. 2.3 ± 1.7 mm3, p = 0.4, respectively). However, when we compared 30 PP lesions with additional ballooning with 55 PP lesions without additional ballooning, there was a trend that cardiac enzymes were increased more significantly in the additional ballooning group compared with the nonadditional ballooning group ( creatine kinase-myocardial band, +14.5 ± 39.3 U/l vs. +10.5 ± 28.9 U/l, p = 0.092, and cardiac troponin I +19.8 ± 63.4 ng/ml vs. +14.5 ± 46.3 ng/ml, p = 0.088, respectively). The incidence of stent thrombosis was not significantly different between the additional ballooning group and the nonadditional ballooning group during 1-month clinical follow-up (1 of 30 [3.3%] vs. 1 of 55 [1.8%], p = 0.8). Therefore, our results suggest that it is not necessary to perform additional ballooning to reduce PP areas when we observe PP after stent implantation in patients with acute myocardial infarction because there are no differences in PP areas and the risk of stent thrombosis, with a strong trend toward more significant myonecrosis in PP lesions with additional ballooning compared with PP lesions without additional ballooning.
* Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, 8 Hak Dong, Dong Ku, Gwangju 501-757, Korea (Email: myungho{at}chollian.net).
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- Hong YJ, Jeong MH, Ahn Y, et al. Plaque prolapse after stent implantation in patients with acute myocardial infarction: an intravascular ultrasound analysis J Am Coll Cardiol Img 2008;1:489-497.[Abstract/Free Full Text]
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Impact of Additional Ballooning on Plaque Prolapse After Stent Implantation in Patients With Acute Myocardial Infarction
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J. Am. Coll. Cardiol. Img. 2008 1: 815.
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