Quantitative angiographic assessment of elastic recoil after percutaneous transluminal coronary angioplasty

Rensing, Benno J.; Hermans, Walter R.M.; Beatt, Kevin J.; Laarman, Gert Jan; Suryapranata, Harry; Brand, Marcel van den; Feyter, Pim J. de; Serruys, Patrick W.

doi:10.1016/0002-9149(90)90501-q

Cited by 149 publications

(37 citation statements)

References 19 publications

(1 reference statement)

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“…Percutaneous coronary intervention (PCI) remains a delicate balance between controlled mechanical disruption and the competing forces of elastic recoil, inflammation, and cell proliferation. 1,2 Although stents have essentially eliminated vessel reocclusion, restenosis has remained a costly and highly morbid problem. [3][4][5] Mechanical disruption of the endothelium and media appears to trigger intimal and vascular smooth muscle proliferation around the stent surface, and borrowing from the oncologic armamentarium, cell-cycle inhibition has been shown to inhibit this process.…”

Section: Resultsmentioning

confidence: 99%

Downstream coronary effects of drug-eluting stents

Krasuski

Cater

Devendra

et al. 2011

American Heart Journal

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Section: Resultsmentioning

confidence: 99%

Downstream coronary effects of drug-eluting stents

Krasuski

Cater

Devendra

et al. 2011

American Heart Journal

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“…Mechanisms involved in early loss are thought to be related to elastic recoil and/or dissection with or without intracoronary thrombosis [13,14]. The occurrence and the magnitude of early recoil may also depend on the specific mechanism of lumen gain and the quality of the residual vessel wall tissue rather than the final MLD alone [9,10,15].…”

Section: Discussionmentioning

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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“…Several studies in the coronary field have shown that a higher balloon/vessel ratio leads to a greater degree of elastic recoil 3,22 . Mummert et al 23 reported, in an experimental model, that aortic root compression forces were dependent on the amount of THV oversizing.…”

Section: Predictors Of Recoilmentioning

confidence: 99%

Incidence, predictive factors and haemodynamic consequences of acute stent recoil following transcatheter aortic valve implantation with a balloon-expandable valve

Nombela‐Franco¹,

Ribeiro²,

Ureña³

et al. 2014

EuroIntervention

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Aims: The elastic behaviour (acute recoil) of a valve prosthesis stent following transcatheter aortic valve implantation (TAVI) is unknown. This study sought to determine the occurrence, severity, predictive factors and haemodynamic consequences of acute recoil following TAVI. Methods and results:A prospective angiographic analysis of the stent frame dimensions in 111 consecutive patients who underwent TAVI with a balloon-expandable valve (36 Edwards SAPIEN; 75 SAPIEN XT) was performed. Acute recoil was defined as the difference between minimal lumen diameter (MLD) at full balloon expansion and immediately after balloon deflation. MLD during balloon inflation was significantly larger than MLD after balloon deflation (23.40±2.31 mm vs. 22.29±2.21 mm, p<0.001), which represented an absolute and percent decrease in stent dimension of 1.10±0.40 mm and 4.70±1.76%, respectively. In the multivariate analysis, the predictors of larger recoil were a higher prosthesis/annulus ratio (r²=0.0624, p=0.015) and the SAPIEN XT prosthesis (r²=0.1276, p=0.001). No significant changes in haemodynamic performance were observed at discharge and follow-up in patients with larger recoil.Conclusions: TAVI with a balloon-expandable valve was systematically associated with a certain degree of valve stent recoil after balloon deflation. A higher degree of valve oversizing and the SAPIEN XT prosthesis predicted a larger degree of stent recoil.

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Quantitative angiographic assessment of elastic recoil after percutaneous transluminal coronary angioplasty

Cited by 149 publications

References 19 publications

Downstream coronary effects of drug-eluting stents

Downstream coronary effects of drug-eluting stents

Histopathological Correlates of Early Arterial Recoil following Directional Coronary Atherectomy

Incidence, predictive factors and haemodynamic consequences of acute stent recoil following transcatheter aortic valve implantation with a balloon-expandable valve

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