Coronary Artery Disease Clinical Trial
Official title:
Influence of Balloon Inflation Techniques and Plaque Characteristics on Stent Under-expansion in Percutaneous RevasculariSaTion (BURST)
This study will look at the effects of standardised balloon inflation times, pressure and balloon types and atherosclerotic plaque morphology on the procedural results of percutaneous coronary intervention (PCI).
Patients presenting with symptoms of coronary artery disease (e.g. chest pain - angina) are
often treated with stents (referred to as percutaneous coronary intervention, PCI). Stents
treat the cause of symptoms by improving blood flow to the heart muscle through expanding a
narrowed, or diseased segment within a coronary artery. The procedure involves the inflation
of a balloon to expand the stent inside the artery. As part of standard clinical care
multiple balloon inflations are required during the procedure. Deficiencies in the expansion
of the stent at the time of the procedure are associated serious complications such as stent
blockages or re-narrowing of the artery, either of which may not occur until much later.
Improvements to the technique of stent expansion are therefore highly desirable to improve
outcomes for patients. A number of factors are thought to influence the success of the
procedure, including: the type of balloon used to inflate the stent, the pressure used and
the duration of balloon inflation. Another important factor may be the mechanical properties
of the narrowed segment of the artery (plaque) and how they interact with the stent. At
present however, there is no consensus view and the practise of individual cardiologists
consequently remains highly variable.
The aim of this study is better characterise relationship between pressure and duration of
balloon inflation, type of balloon used and plaque properties during stent procedures using
state-of-the-art imaging. Although assessment of each of these factors by a cardiologist is
already included as part of standard care, our research protocol will focus the analysis into
a systematic framework to allow conclusions to be drawn. The findings will used better inform
cardiologists of the technical modifications that can help improve stenting procedures and
translate to better outcomes for patients.
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