الفهرس 
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Abstract
PPCI is considered to be the preferred reperfusion strategy for acute coronary syndrome (ACS). The goal of reperfusion is to resume normal blood flow to the cardiac tissues, and not just to achieve an open epicardial artery. Although no-reflow may occur regardless of the method of revascularization, it is easily diagnosed with certainty during acute percutaneous coronary intervention (PCI) in STEMI.
The pathophysiology of NR is complex and is not fully understood; it involves much more than just distal embolization of thrombotic debris.
No-reflow is a multifactorial and complex phenomenon, and an independent marker of clinical adverse outcome in STEMI patients.
Our study aimed to evaluate the efficacy of Deflated Balloon-Facilitated Direct Stenting in comparison with routine Balloon Pre-dilatation in STEMI Patients undergoing PPCI.
It included 160 patients who were presented with ST segment elevation myocardial infarction (STEMI) and underwent primary PCI at Ain Shams University Hospitals and Misr University for Science and Technology (MUST) university hospital in the period of March 2021 to december 2021.
Results for age, gender, hypertension, family history and diabetes did not show any statistical significance of value between the both groups. Significant differences were found as regards smoking {70% in group 1 and 51.67% in group2}, with p-value 0.04 and dyslipidemia {5% in group 1 and 16.67% in group 2} with p-value 0.04
In our study, group 2 showed the best results as regards No-reflow (23.33% vs 6.67% vs 27.5% in group 1, 2 and 3 respectively) with p-value (0.011), final MBG (II-III) (76.67% vs 93.33% vs 72.5% in group 1, 2 and 3 respectively) with p-value (0.011) and final TIMI III (91.67% vs 95% vs 90% in group 1, 2 and 3 respectively) with p-value (0.838). It was found that group 1 showed the shortest procedure time (46.83±15.43 vs 52±13.54 vs 59.75±14.59, in group 1, 2 and 3 respectively) with p-value (0.054) and smallest contrast volume (101±19.09 vs 120.67±28.99 vs 136.25±24.67, in group 1, 2 and 3 respectively) with p-value (<0.001). While group 3 had the worst outcomes among all groups.
In summary, our study concluded that the routine balloon predilatation caries better outcomes than deflated balloon facilitated direct stenting in primary PCI.
Based on the results of this study, we recommend the use of routine balloon predilatation over deflated balloon facilitated direct stenting in the setting of primary PCI in patients presenting with STEMI.