Sub-analysis of perfusion balloon predilatation with intracoronary nicorandil vs. distal protection for acute coronary syndrome: A comparative evaluation.

Objectives: Slow-flow or no-reflow events occur as a complication during percutaneous coronary intervention for acute coronary syndrome (ACS). A previous study demonstrated that prolonged perfusion balloon (PB) predilatation combined with intracoronary administration of nicorandil attenuates this phenomenon. This subanalysis compared the efficacy of the PB approach with that of conventional distal protection (DP). Methods: PB, with simultaneous intracoronary administration of nicorandil 2 mg without a DP device and subsequent placement of a drug-eluting stent. The DP group underwent direct stenting or predilatation with a standard balloon combined with a DP device without a PB. Primary endpoints included the incidence of slow-flow or no-reflow events. Results: Sixty-four patients with ACS were enrolled (PB group, n=32; DP group, n=32). The incidence of slow-flow or no-reflow events was significantly lower in the PB group (3.1% vs. 46.8%, p