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Titolo:
CORONARY HEMODYNAMICS BEFORE AND AFTER ROTATIONAL ATHERECTOMY WITH ADJUNCTIVE BALLOON ANGIOPLASTY
Autore:
NUNEZ BD; KEELAN ET; HIGANO ST; LERMAN A; GARRATT KN; HOLMES DR;
Indirizzi:
MAYO CLIN & MAYO FDN,ADULT CARDIAC CATHETERIZAT LAB,200 1ST ST SW ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,ADULT CARDIAC CATHETERIZAT LAB ROCHESTER MN 55905
Titolo Testata:
Catheterization and cardiovascular diagnosis
, volume: 38, anno: 1996, supplemento:, 3
pagine: 40 - 49
SICI:
0098-6569(1996)38:<40:CHBAAR>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-FLOW VELOCITY; NO-REFLOW PHENOMENON; SUBSELECTIVE MEASUREMENT; INTRACORONARY VERAPAMIL; VENTRICULAR-FUNCTION; VASODILATOR RESERVE; ARTERY DISEASE; GUIDE WIRE; LESIONS; OCCLUSION;
Keywords:
NO-REFLOW; PHENOMENON; ROTATIONAL ATHERECTOMY; CORONARY FLOW; VERAPAMIL; NITROGLYCERIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
42
Recensione:
Indirizzi per estratti:
Citazione:
B.D. Nunez et al., "CORONARY HEMODYNAMICS BEFORE AND AFTER ROTATIONAL ATHERECTOMY WITH ADJUNCTIVE BALLOON ANGIOPLASTY", Catheterization and cardiovascular diagnosis, 38, 1996, pp. 40-49

Abstract

The phenomenon of ''no-reflow'' has been described frequently after rotational atherectomy. The aim of this study was to determine the coronary hemodynamic changes by Doppler flow wire before and after rotational atherectomy and adjunctive balloon angioplasty in 10 patients. Allpatients had TIMI-III flow at baseline. After rotational atherectomy alone, two patients had TIMI-I, four patients had TIMI-II, and four patients had TIMI-III flow. In addition, the number of Cineframes to Opacification of a preselected distal landmark increased twofold (from 49+/- 12 to 118 +/- 27 frames; P<0.05). Intracoronary nitroglycerin andverapamil was associated with return to baseline of both measurments. Following adjunctive balloon angioplasty, there was an increase in lumen diameter (1.29 +/- 0.1 vs. 2.6 +/- 0.1 mm; P<0.05), coronary flow (81 +/- 14 to 154 +/- 18 ml/min; P<0.05), maximal absolute velocity (23 +/- 4 to 52 +/- 4 cm/sec; P<0.05), and vascular resistance decreased(1.74 +/- 0.4 to 0.74 +/- 0.4 mm Hg/ml/min; P<0.05). However, no change in coronary flow reserve was noted (1.24 +/- 0.1 vs. 1.5 +/- 0.3). Immediately after rotational atherectomy alone, there is a reduction in angiographically determined coronary flow, suggesting either distal microvascular spasm or distal microvascular obstruction. Regardless ofthe mechanism, the transient reduction of coronary flow was rapidly reversed by coronary vasodilators. Despite the significant improvement of coronary hemodynamics noted immediately after combined rotational atherectomy and balloon angioplasty, coronary flow reserve remained abnormal. Similarly, no change in coronary flow reserve has been reportedimmediately after balloon angioplasty alone. The lack of improvement in flow reserve after both balloon angioplasty and rotational atherectomy suggests that the mechanisms of improved flow reserve may be device independent, and remain unexplained. (C) 1996 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/07/20 alle ore 08:00:59