Regional differences in elastic recoil after percutaneous transluminal coronary angioplasty: A quantitative angiographic study

Abstract

The immediate result of percutaneous transluminal coronary angioplasty is influenced by both plastic and elastic changes of the vessel wall. To evaluate the amount of elastic recoil after coronary balloon angioplasty, the minimal luminal cross-sectional area of the largest balloon used at highest inflation pressure was compared with the minimal luminal vessel cross-sectional area directly after final balloon deflation in 607 lesions (526 patients). Elastic recoil was defined as the difference between balloon cross-sectional area and minimal luminal cross-sectional area of the dilated coronary segment immediately after balloon withdrawal. A videodensitometric analysis technique was used to avoid geometric assumptions on stenosis morphology directly after angioplasty. Mean balloon cross-sectional area was 5.3 +/- 1.6 mm2 and minimal luminal cross-sectional area after angioplasty was 2.8 +/- 1.4 mm2. Reference areas before and after angioplasty did not differ (6.0 +/- 2.6 and 6.2 +/- 2.6 mm2, respectively). Univariate analysis revealed that asymmetric lesions, lesions located in less angulated parts of the artery and lesions with a low plaque content showed more elastic recoil. Lesions located in distal parts of the coronary tree were also associated with more elastic recoil probably related to relative balloon oversizing in these distal lesions.

Cutting Balloon Angioplasty and Stent Implantation for Aorto‐ostial Lesions: Clinical Outcome and 1‐year Follow‐up

“…Rensing et al reported that elastic recoil in aorto-ostial lesions reaches 50%. 9 Conventional balloon angioplasty causes insufficient dilatation and a high rate of restenosis 3 because of the significant radial strength and elastic properties of the aorta-ostial lesions. Thus, the conventional balloon has to be inflated to a higher pressure and this may cause significant vessel injury, unpredictable dissections, and distal embolization.…”

Histopathological Correlates of Early Arterial Recoil following Directional Coronary Atherectomy

“…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]. Lesions with an eccentric or small plaque area and/or with a small radius of curvature have been associated with accentuated elastic recoil after angioplasty [8]. Intravascular ultrasound data correlated early elastic recoil with absence of any plaque 'cracking' during balloon angioplasty [9,10].…”

Restenosis Treatments Using Nanoparticle-based Drug Delivery Systems

“…1C). This results in an exaggerated wound healing response, involving a combination of processes, including elastic recoil [13], thrombus formation [14], inflammation [15], neointimal formation and arterial remodelling [5].…”