{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:05:38Z","timestamp":1767373538391,"version":"3.41.2"},"reference-count":24,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Interv Cardiol"],"abstract":"<jats:p>Background: In primary percutaneous coronary intervention (pPCI), balloon predilation is frequently carried out before stenting but there is a lack of data regarding optimal balloon size and the effect of balloon size on procedural and clinical outcomes. Aims: This study compares small balloon predilation (\u226450% of proximal vessel diameter) with large balloon predilation (&gt;50% of proximal vessel diameter) in pPCI. Methods: This multicentre prospective observational study included consecutive ST elevation MI (STEMI) patients undergoing pPCI at three tertiary centres in Egypt. Demographic, clinical and angiographic data were collected for all the patients. The primary outcome was the presence of no reflow at the conclusion of the procedure and secondary outcomes included procedural complications \u2013 no reflow, dissection, abrupt vessel closure, fluoroscopy time and procedural time \u2013 and clinical outcomes \u2013 in-hospital left ventricular ejection fraction (LVEF), cardiogenic shock, stent thrombosis, ventricular fibrillation, stroke, death, ST-segment resolution &gt;50% 1 hour after PCI and LVEF at discharge. Results: A total of 384 pPCI procedures were included. The small balloon group (n=222) and the large balloon group (n=162) were comparable in terms of baseline characteristics. The large balloon group had a significantly higher incidence of no reflow (n=23 [14.2%] versus n=6 [2.7%], p&lt;0.001), procedural complications: n=31 [19.4%] versus n=10 [4.5%], p&lt;0.001) and contrast volume (190.4 \u00b1 40.2 ml versus 177.4 \u00b1 29.4 ml, p=0.0003) compared to the small balloon group. ST-segment resolution &gt;50% after PCI was more frequent in the small balloon group (n=182 [81.98%] versus n=109 [67.28%], p&lt;0.001). Conclusion: This study suggests that using a smaller balloon size for predilation in pPCI is associated with improved coronary flow, reduced procedural complications and better ST-segment resolution.<\/jats:p>","DOI":"10.15420\/icr.2024.12","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T10:09:17Z","timestamp":1745402957000},"source":"Crossref","is-referenced-by-count":1,"title":["Predilation in Primary Percutaneous Coronary Intervention"],"prefix":"10.15420","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-4260","authenticated-orcid":false,"given":"Mahmoud","family":"Tantawy","sequence":"first","affiliation":[{"name":"College of Medicine, Department of Cardiology, Misr University for Science and Technology, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Saad","sequence":"additional","affiliation":[{"name":"Brown University Health Cardiovascular Institute, Division of Cardiology, Alpert Medical School Department of Medicine, Brown University, Providence, RI, U"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif","family":"Hussien","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Cardiology, Misr University for Science and Technology, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghada","family":"Selim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Tamara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6096","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC\/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019;40:87\u2013165. https:\/\/doi.org\/10.1093\/eurheartj\/ehy394; PMID:\u00a030165437.","DOI":"10.1093\/eurheartj\/ehy855"},{"key":"ref1","unstructured":"Writing Committee Members. 2021 ACC\/AHA\/SCAI Guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association Joint\u00a0Committee\u00a0on\u00a0Clinical Practice Guidelines. J Am Coll Cardiol 2022;79:e21\u2013e129. https:\/\/doi.org\/10.1016\/j.jacc.2021.09.006; PMID:\u00a034895950."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bessonov\u00a0I,\u00a0Zyrianov\u00a0I,\u00a0Kuznetsov\u00a0V, et al. TCTAP A-024 comparison of direct stenting versus pre-dilation in ST-elevation myocardial infarction. J Am Coll\u00a0Cardiol 2016;67(Suppl):S10. https:\/\/doi.org\/10.1016\/j.jacc.2016.03.035.","DOI":"10.1016\/j.jacc.2016.03.035"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Ly HQ, Kirtane AJ, Buros J, et al. 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