Large and small vessel vasoconstriction following coronary artery stenting

Larsen, Alf Inge; Basran, Rashpal; Anderson, Todd J.; Goodhart, David

doi:10.1016/j.ijcard.2005.10.027

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Supporting this, is a randomized trial of direct stenting compared to stenting with predilatation (more complex technique), indicating that direct stenting with fewer dilatations is less traumatic for the coronary microcirculation as compared to conventional stenting [23]. Elective PCI might impair resting microvascular perfusion [24] through several different mechanisms acutely elevating the coronary microcirculatory resistance; release of local vasoconstrictors [25], vasoconstriction [26], impairment of endothelial function [27, 28], and distal embolization [29, 30]. Microvascular impairment is more likely to occur during more complex PCI and/or in very long lesions than in less complex interventions.…”

Section: Discussionmentioning

confidence: 99%

Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Ekenbäck

Jokhaji

Östlund-Papadogeorgos

et al. 2019

Journal of Interventional Cardiology

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Aim To investigate the relationship between stent length and changes in microvascular resistance during PCI in stable coronary artery disease (CAD). Methods and Results We measured fractional flow reserve (FFR), index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) before and after stenting in 42 consecutive subjects with stable coronary artery undergoing PCI with stent in the LAD. Patients that had very long stent length (38–78 mm) had lower FFR before stenting than patients that had long (23–37 mm) and moderate (12–22 mm) stent length (0.59 (±0.16), 0.70 (±0.12), and 0.75 (±0.07); p=0.002). FFR improved after stenting and more so in subjects with very long stent length compared to long and moderate stent length (0.27 (s.d ± 16), 0.15 (s.d ± 0.12), and 0.12 (s.d ± 0.07); p for interaction = 0.013). Corrected IMR (IMRcorr) increased after stenting in subjects who had very long stent length, whereas IMRcorr was lower after stenting in subjects who had long or moderate stent length (4.6 (s.d. ± 10.7), −1.4 (s.d. ± 9,9), and −4.2 (s.d. ± 7.8); p for interaction = 0.009). Conclusions Changes in IMR during PCI in the LAD in stable CAD seem to be related to total length of stents implanted, possibly influencing post-PCI FFR. Larger studies are needed to confirm the relationship.

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Section: Discussionmentioning

confidence: 99%

Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Ekenbäck

Jokhaji

Östlund-Papadogeorgos

et al. 2019

Journal of Interventional Cardiology

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“…4 The immediate effect of stenting on microvascular endothelial function is one of them. There is a down-regulation of eNOS, and increased release of the vasoconstrictors serotonin and endothelin-1 in a vessel exposed to low shear stress.…”

Section: Discussionmentioning

confidence: 99%

“…There is a down-regulation of eNOS, and increased release of the vasoconstrictors serotonin and endothelin-1 in a vessel exposed to low shear stress. 4 - 7 Glyceryl trinitrate acts by releasing nitric oxide and known as a potent vasodilator. The use of intacoronary glyceryl trinitrate is beneficial in resolving coronary vasospasm.…”

Section: Discussionmentioning

confidence: 99%

Migration of fully deployed stent after intracoronary glyceryl trinitrate administration: An unusual percutaneous coronary intervention complication

Çelik

Gökoğlan

2013

Pak J Med Sci

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Stent embolization is a rare complication of coronary stenting. If left untreated, it may lead to devastating consequences. Although there is much known about stent embolization, data about migration of stent after deployment is limited. We report an unusual case of a deployed stent migration into the distal part of right coronary artery after intracoronary glyceryl trinitrate administration during percutaneous coronary intervention.

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“…These effects were reversed by NTG. Serum levels of LDL were modestly related to the reduction of CBF and to the degree of NTG-induced vasodilatation of the coronary microvasculature [ 27 ].…”

Section: Etiologymentioning

confidence: 99%

Myocardial Microvascular Physiology in Acute and Chronic Coronary Syndromes, Aortic Stenosis, and Heart Failure

Larsen

Fearon

Anderson

et al. 2022

Journal of Interventional Cardiology

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Large and small vessel vasoconstriction following coronary artery stenting

Cited by 4 publications

References 25 publications

Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Migration of fully deployed stent after intracoronary glyceryl trinitrate administration: An unusual percutaneous coronary intervention complication

Myocardial Microvascular Physiology in Acute and Chronic Coronary Syndromes, Aortic Stenosis, and Heart Failure

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