Early decrease in minimal luminal diameter after successful percutaneous transluminal coronary angioplasty predicts late restenosis

Rodriguez, Alfredo; Santaera, Omar; Larribeau, Miguel; Sosa, María Isabel; Palacios, Igor F.

doi:10.1016/0002-9149(93)90598-7

Cited by 54 publications

(12 citation statements)

References 23 publications

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“…When present early, recoil is associated with a high frequency of restenosis (74% compared to 10% in those without recoil). 2 When lesions with recoil were randomised to either medical therapy alone or to elective stenting, restenosis was significantly reduced (76% versus 21%) among those receiving intracoronary stents.…”

Section: Cpdmentioning

confidence: 98%

Percutaneous Coronary Interventions: what the general practitioner should know

2005

South African Family Practice

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Section: Cpdmentioning

confidence: 98%

Percutaneous Coronary Interventions: what the general practitioner should know

2005

South African Family Practice

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“…Este estudo mostra, também, que o recolhimento elástico imediato do vaso é fator determinante da lesão residual ao final do procedimento. Em outra publicação, Rodriguez e col 24 demonstraram que uma perda >0,3mm no DLM ou um incremento de 10% no diâmetro da obstrução após 24h da angioplastia estratificam lesões com maior propensão de desenvolver reestenose no seguimento tardio. Em nossa casuística, similarmente, o recolhimento elástico absoluto e relativo nas angiografias do 1° e do 15°min foram maiores no grupo com reestenose.…”

Section: Referênciasunclassified

“…1). Este achado converge com os de estudos recentes 24,25 , sugerindo que o aumento na relação balão/artéria interfere favoravelmente no índice de reestenose. Esses autores observaram que uma relação balão/artéria >0,9 determina menores lesões residuais ao final do procedimento e, por conseguinte, menor índice de reestenose.…”

Section: Referênciasunclassified

A perda precoce do diâmetro luminal após angioplastia coronária e sua influência no fenômeno da reestenose

Caixeta¹,

Brito²,

Horta³

et al. 1997

Arq. Bras. Cardiol.

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“…Rodriguez et al [6] used a repeat angiography at 24 h to show that approximately 30% of the patients had a 110% loss of luminal diameter in comparison with the immediate postangioplasty result and that this vessel wall reaction correlated strongly with late restenosis. We have previously reported that early loss of procedural luminal gain may be apparent as early as 15 min after completion of conventional balloon angioplasty [7].…”

Section: Introductionmentioning

confidence: 99%

Histopathological Correlates of Early Arterial Recoil following Directional Coronary Atherectomy

Dangas

Peters-Veluthamaningal²,

Cocke³

et al. 1998

Cardiology

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Elastic recoil has been implicated in the pathophysiology of restenosis after conventional balloon angioplasty alone. Directional atherectomy may attenuate arterial recoil by removing the internal elastic lamina and medial smooth muscle cells and altering the vessel wall architecture. This study sought to evaluate early recoil after directional atherectomy and its relation with excision of deep arterial wall structures. We prospectively evaluated the correlation of the histopathologic evidence of media or adventitia as assessed in the atheroma retrieved during the procedure with the early changes in minimal lumen diameter after directional atherectomy followed by adjunct balloon dilatation in 50 consecutive cases. Recoil was assessed by routinely performed 1- and 15-min postprocedure angiograms, and patients were divided into two groups according to the absence (group I, n = 26) or presence (group II, n = 24) of recoil. The mean changes in minimal luminal diameter between 1 and 15 min was +0.22 mm in group I and –0.14 mm in group II. The absence of recoil was strongly associated with evidence of media tissue in the pathologic analysis as compared with cases with recoil (42 vs. 18%, respectively; p = 0.02). Similarly, retrieval of adventitia was seen exclusively in the group without recoil (15 vs. 0%; p = 0.06). Vessels that underwent recoil had significantly larger reference and immediate postprocedure minimal luminal diameters (3.62 ± 0.57 and 3.02 ± 0.45 mm, respectively) as compared with arteries with no recoil (3.28 ± 0.35 and 2.75 ± 0.43 mm, respectively; p < 0.05 for both). Therefore, early luminal changes, likely related to elastic recoil, correlated with excision of deep wall structures during directional atherectomy. Arteries that showed recoil were larger, possibly due to thicker muscular layer and/or larger plaque burden as compared with arteries that did not recoil. Thus, optimal tissue debulking during directional atherectomy appears to attenuate recoil, providing an additional insight into the mechanism of action of this percutaneous revascularization device.

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Early decrease in minimal luminal diameter after successful percutaneous transluminal coronary angioplasty predicts late restenosis

Cited by 54 publications

References 23 publications

Percutaneous Coronary Interventions: what the general practitioner should know

Percutaneous Coronary Interventions: what the general practitioner should know

A perda precoce do diâmetro luminal após angioplastia coronária e sua influência no fenômeno da reestenose

Histopathological Correlates of Early Arterial Recoil following Directional Coronary Atherectomy

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