Perfusion balloon (PB) is a practical device for percutaneous coronary intervention (PCI) for unstable lesions that allows distal coronary flow during balloon occlusion, as it is equipped with multiple holes both in the proximal and distal parts of the balloon (Fig. 1A) [1]. Furthermore, recent studies demonstrated the efficacy of intracoronary administration of vasodilators, such as nicorandil, during PB inflation in increasing distal coronary flow [2, 3]. However, its impact on changes in electrocardiography (ECG) remains unclear.
Fig. 1
ECG Changes following Intracoronary Nicorandil through Perfusion Balloon. A PB has multiple holes both in the proximal and distal parts of the balloon, facilitating blood flow from the proximal to distal segments of the balloon shaft. B Vulnerable plaques on intravascular ultrasound. C Preserved distal coronary flow (yellow arrowheads) following PB (blue dotted line) inflation. D ST-segment elevation in leads II, III, and aVF with reciprocal ST-segment depression in leads I, aVL, V1-5 after PB inflation. E ST-segment elevation resolution following intracoronary nicorandil administration. PB perfusion balloon
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