POSTDIL-STEMI
Research type
Research Study
Full title
The effect of post stenting balloon dilatation on coronary microcirculation in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).
IRAS ID
197809
Contact name
John Davies
Contact email
Sponsor organisation
Basildon and Thurrock University Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
A heart attack is caused by an acute blockage of one of the vessels supplying blood to the heart due to clot formation. The optimal treatment is to restore blood flow by unblocking the vessel with a sophisticated technique that uses special catheters, wires and balloons. After that most of the time we need to place a small metallic tube called a stent to keep the vessel open. The stent is delivered into the vessel over a wire and it is placed with balloon inflation. Sometimes its placement is not optimal as it is not well expanded or there is a gap between it and the vessel wall. Suboptimal placement increases the risk of new clot formation and vessel blockage over time. Thus we try to optimise the stent after its placement by further balloon inflations, a procedure called post-dilatation. There are contradictory data on whether this procedure can cause clot embolization to the to the very distal and small vessels of the heart muscle (coronary microcirculation).
The POSTDIL study will try to assess the impact of post-dilatation on coronary microcirculation in patients having stents in the context of acute heart attack. We will collect information with a wire that can measure blood pressure, flow and temperature in the heart vessels and a catheter that provides live images of the inside of the vessel. Both are standard tools occasionally used during treatment of heart attack and stent placements.
We aim to recruit 30 patients over a 12-month period, within the Essex Cardiothoracic Centre (CTC). Patients eligible will be those presenting with acute heart attack due for emergency procedure. Patients will undergo their standard artery unblocking procedure with stents, but in cases where post-dilatation is needed they will also have microcirculation function assessment and intracoronary imaging before and after the post-dilatation.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
16/EE/0096
Date of REC Opinion
24 May 2016
REC opinion
Further Information Favourable Opinion