Document Detail


Assessment of coronary artery stenosis during PTCA by measurement of the trans-stenotic pressure gradient. Comparison with quantitative coronary angiography.
MedLine Citation:
PMID:  8746905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A fibreoptic pressure sensor mounted on an 0.018 inch guidewire (Pressure Guide, RadiMedical Systems, Uppsala, Sweden) was used to measure the trans-stenotic pressure gradient in 20 patients admitted for percutaneous transluminal coronary angioplasty (PTCA) of a single, discrete stenosis. Pressure measurements were made both at rest and during maximal vasodilatation induced by intracoronary injection of papaverine. From the ratio of distal coronary pressure divided by the proximal pressure, the relative coronary flow reserve was calculated. The aim of the study was to compare the different pressure-derived parameters by correlating them to stenosis geometry estimated by quantitative coronary angiography. There was a moderate correlation between baseline pressure gradient and percent area stenosis; r = 0.64, P < 0.001 and minimal cross-sectional area; r = 0.45, P < 0.005. A higher correlation was found between hyperaemic pressure gradient and area stenosis (r = 0.80, P < 0.001) and minimal cross-sectional areas, respectively (r = 0.55, P < 0.005). The best correlation was found between relative coronary flow reserve and area stenosis (r = 0.86, P < 0.001) and minimal cross-sectional area (r = 0.70, P < 0.001). In conclusion, pressure measurement using a pressure guidewire is useful as a complement to angiography in evaluation of coronary stenoses during PTCA. Pressures should be measured during maximal vasodilatation. Relative coronary flow reserve calculated from the pressure measurements provides additional information about the fraction of normal maximal flow possible in the presence of a stenosis.
Authors:
C Lamm; P Albertsson; M Dohnal; U Tylén; H Emanuelsson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  16     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-09-26     Completed Date:  1996-09-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1367-74     Citation Subset:  IM    
Affiliation:
Department of Radiology, Sahlgrenska University Hospital, Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Blood Pressure / drug effects,  physiology*
Coronary Angiography*
Coronary Circulation / drug effects,  physiology*
Coronary Disease / diagnosis,  physiopathology,  therapy*
Female
Fiber Optic Technology / instrumentation*
Humans
Hyperemia / physiopathology
Male
Middle Aged
Papaverine / administration & dosage
Signal Processing, Computer-Assisted
Treatment Outcome
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-74-2/Papaverine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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