Читать книгу Interventional Cardiology - Группа авторов - Страница 138

Balloon catheters remain an important tool in interventional cardiology despite the advent of adjunctive devices such as stents. When Gruentzig first introduced coronary angioplasty balloons, the correct choice of balloon diameter and length, compliance, pressure, and duration of inflation were the key ingredients for a successful PCI and reflected the experience and quality of individual operators. There has been a period when direct stent deployment became fashionable. The fact that stents can be inserted without pre‐dilatation in most cases, however, does not mean that this is a good idea, with the possible exception of some primary angioplasty for thrombus containing lesions or frail lesions in SVGs. Lack of predilatation means inability to spot undilatable lesions, leaving unexpanded stents and underestimation of true vessel size. Post‐dilatation has now become standard of care for most lesions in experienced hands. With the advent of drug‐coated balloons, angioplasty balloons are also able to deliver more than acute gain from vessel dilatation, with adjunctive pharmacotherapy able to mitigate neointimal hyperplasia and reduce restenosis.