Sirolimus-Eluting Balloon for the Treatment of Coronary Lesions in Complex ACS Patients: The SELFIE Registry

Figures

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  Figure 1. STEMI patients undergoing PCI with the SCB of de novo lesions in small vessels. Upper panels ((a)–(e)): total thrombotic occlusion of proximal posterolateral branch of the RCA (a) in a patient with inferior STEMI treated with a 2.25 × 12 mm balloon ((b) and (c)) and 2.25 × 30 mm SCB (d) with good TIMI 3 final result (e). Lower panels ((f)–(j)): total thrombotic occlusion of proximal first diagonal branch (f) in a patient with lateral STEMI treated with a 2.25 × 15 mm balloon ((g) and (h)) and 2.25 × 30 mm SCB (i) with good TIMI 3 final result (j).

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  Figure 2. STEMI patient undergoing PCI with the SCB of ISR lesion on LAD. A patient with anterior STEMI for ISR on LAD (a) underwent PCI with a 2.75 × 12 mm noncompliant balloon (b), 3.0 × 15 mm noncompliant balloon (c), and 3.0 × 15 mm SCB (d), with good final angiographic result and TIMI 3 flow ((e) and (f)).

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  Figure 3. NSTEMI patient undergoing OCT-guided PCI with the SCB of ostial ISR on RCA. A patient with NSTEMI showing significant stenoses of the distal RCA with significant ISR at the ostium (a). All lesions were predilated with a 2.0 × 20 noncompliant balloon ((b) and (c)). A linear dissection became evident in the distal segment (d) and was covered with a 2.25 × 35 mm DES (e) postdilated with a noncompliant 2.5 × 12 mm balloon (f). The OCT pullback of the ostial ISR revealed a typical fibrotic pattern of neointimal hyperplasia causing significant restenosis (g). The lesion was treated with several inflations of a 3.5 × 15 mm noncompliant balloon at high atmospheres (h) and with a 3.5 × 15 mm SCB afterward (i). Final OCT pullback (j) showed a significant improvement of the MSA with a small neointimal dissection (see asterisk).

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  Figure 4. NSTEMI patient undergoing PCI with the SCB of de novo lesion with a 3-month angiographic follow-up. A patient with NSTEMI and a significant stenosis in the proximal segment of a collateral branch (small diameter but good extension) of the I diagonal (a); the lesion was treated with a 2.0 × 12 mm noncompliant balloon (b) and a 2.25 × 15 mm SCB (c) with good final angiographic result and TIMI 3 flow (d). The angiographic follow-up at 3 months is reported (e) with no restenosis nor thrombosis of the treated lesion.

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  Figure 5. Kaplan–Meier curve of survival from the secondary study endpoint, MACE, at the longest available follow-up. MACE = major cardiovascular events.