The inflated balloon – A possible cause of microvascular obstructions


A serious complication of coronary interventions is thromboembolism which might be caused by the detachment of platelet aggregates. One possible cause are small thrombogenic particles from the inflated balloon surface. The gliding layer of a balloon catheter was analyzed by means of a back scatter electron detector in a scanning electron microscope. The average element composition of the gliding layer was assessed of a non-inflated and a inflated balloon. It could be shown that there was a continuous layer of silicon at the surface of the non-inflated balloon. After inflation of a new balloon, however, there was only a very thin and discontinuous silicon layer showing big holes. It seems to be possible that parts of the gliding layer flaked off the balloon surface leaving only “plaques of silicon” on the balloon surface. Detached silicon plaques surely would be thrombogenic and have therefore the potential to obstruct small myocardial arterioles and capillaries.
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